HEALTH

Tricare expands vaccination coverage to pharmacies, clinics

BY Michael Johnsen

FALLS CHURCH, Va. The Department of Defense on Thursday issued an interim final rule through the Federal Register designating pharmacies as providers for H1N1, seasonal flu and pneumonia vaccinations under its Tricare program. The policy change, effective immediately and expected to be fully implemented later this month, brings the program in line with other insurers that have covered pharmacist-administered vaccinations.

“NCPA strongly supports the Pentagon’s decision to cover the provision of these critical vaccines at community pharmacies,” stated Bruce Roberts, EVP and CEO of the National Community Pharmacists Association. “The 9.5 million Tricare-eligible patients gain a convenient new vaccination option,” he said. “[And] taxpayers and plan administrators will save money when vaccines are administered at pharmacies instead of costlier doctors’ offices or hospitals.”

The National Association of Chain Drug Stores also commended the decision, stating that pharmacies “[are] uniquely positioned to offer such services for patients as vaccinations.”

“With the flu season upon us, it is important to help patients stay as healthy as possible. And for Tricare patients, this ruling provides them the ability to access their neighborhood pharmacy to receive these vaccinations,” said NACDS president and CEO Steve Anderson.

Tricare also is seeking comments on additional vaccines that should be covered through community pharmacies.

Tricare also recently added local convenient care clinics as network providers, meaning Tricare covered can also visit their local Take Care Health or MinuteClinic for influenza vaccines, the military payor announced last month.

Along with getting their flu shots at local military treatment facilities and from their primary care manager, nonactive duty Tricare Prime beneficiaries in the North and South regions can now receive flu vaccinations at local convenient care clinics. Tricare Standard or Extra beneficiaries who are not Medicare-eligible can also take advantage of the convenient care clinics, now that Tricare has waived cost shares for immunizations received from network providers.

“Convenient care clinics may be the perfect option for busy families to take advantage of this important preventive care,” Tricare stated in a press release.

In the North Region, Health Net has contracted with convenient care clinics at all MinuteClinics in CVS pharmacies; Take Care Clinics in Walgreens; and Little Clinics in Kroger food stores. In the South Region, Humana Military has limited service clinics at MinuteClinics in CVS pharmacies.

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Autopsies reveal H1N1 virus can damage entire airway

BY Michael Johnsen

NEW YORK Researchers from the National Institutes of Health and the New York City Office of Chief Medical Examiner on Monday reported that the H1N1 virus can damage cells throughout the respiratory airway, similar to the pandemics occurring in 1918 and 1957.

“This study provides clinicians with a clear and detailed picture of the disease caused by 2009 H1N1 influenza virus that will help inform patient management,” stated Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “In fatal cases of 2009 H1N1 influenza, it appears the novel pandemic influenza virus produces pulmonary damage that looks very much like that seen in earlier influenza pandemics.”

The new report also underscores the impact 2009 H1N1 influenza is having on younger people. While most deaths from seasonal influenza occur in adults over 65 years old, deaths from 2009 H1N1 influenza occur predominately among younger people. The majority of deaths (62%) in the 34 cases studied were among those 25 to 49 years old; two infants were also among the fatal cases.

The scientists reviewed autopsy reports, hospital records and other clinical data from 34 people who died of 2009 H1N1 influenza infection between May 15 and July 9, 2009. All but two of the deaths occurred in New York. A microscopic examination of tissues throughout the airways revealed that the virus caused damage primarily to the upper airway — the trachea and bronchial tubes — but tissue damage in the lower airway, including deep in the lungs, was present as well. Evidence of secondary bacterial infection was seen in more than half of the victims.

Nine-out-of-ten of those autopsied had underlying medical conditions, such as heart disease or respiratory disease, including asthma, before becoming ill with 2009 H1N1 influenza; and 72% of the adults and adolescents who died were obese.

The findings are reported in the Archives of Pathology & Laboratory Medicine, now available online and scheduled to appear in the February 2010 print issue.

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Research notes lack of vitamin D in one’s diet can lead to serious conditions

BY Michael Johnsen

BOSTON New research underscores that having too little vitamin D can contribute to heart disease, brittle bones, breast cancer, prostate cancer, depression and memory loss, according to the December 2009 issue of the Harvard Heart Letter.

Following are some of the highlights:

  • Calcium deposits that stiffen the arteries are more likely to develop in people with low levels of vitamin D. In one study, men low in vitamin D were twice as likely to develop heart disease;
  • Vitamin D decreases the kidneys’ production of renin, a hormone that boosts blood pressure. Several studies suggest that low vitamin D contributes to high blood pressure, and that getting more of the vitamin can help control blood pressure;
  • Some people who take a cholesterol-lowering statin stop because of muscle pain. In a study of 128 men and women with statin-related muscle pain, two-thirds of them had low vitamin D levels. Among those who took a vitamin D supplement, muscle pain disappeared in 90%;
  • Preliminary trials suggest that too little vitamin D can leave the body prone to infection, and having enough in circulation can help the body fight off the flu, tuberculosis and infections of the upper respiratory tract.

The Harvard Heart Letter noted that supplements are the best way to get vitamin D.

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