What is the DOD P&T Committee?

Bottom line:

Pharmaceutical manufacturers need to understand the role, responsibilities, and process of the DOD P&T Committee since TRICARE formulary placement is crucial to patient access within this healthcare system.

The Department of Defense (DOD) Pharmacy and Therapeutics (P&T) Committee within the Defense Health Agency (DHA) plays a vital and specific role in managing healthcare costs. Its responsibilities are formalized in a standing charter that is reviewed every five years. Through its careful analysis and rigorous evaluations, this Committee maintains the high standard of care within the DOD healthcare system for military beneficiaries.

The DOD P&T Committee meets every quarter to review newly approved drugs, existing drug classes in totality, and, at times, evaluates utilization management all with the primary purpose of ensuring military beneficiaries have access to safe and effective medications. Its evaluations include both clinical effectiveness and the appropriateness of prior authorization requirements or step therapy protocols as well as cost evaluations that analyze the cost of the drug product relative to its understood safety and effectiveness as compared to the other drug agents in the therapeutic class.

The DOD P&T Committee includes a multidisciplinary panel of physicians, pharmacists, and other healthcare professionals that maintain a uniform formulary to guarantee consistent medication availability across the health system. It includes 20 voting members from DHA, Navy, Army, Airforce, Coast Guard and TRICARE representing a variety of both healthcare operation functions (including the DHA Clinical Support Division Chief, the DHA Pharmacy Operations Division Chief, the DHA Formulary Management Branch Chief, etc.) and providers/experts from medical specialties (such as, family medicine, pediatrics, oncology, etc.). The Committee also includes non-voting members from the DHA Office of General Counsel, DHA Contracting, the Defense Logistics Agency, the TRICARE Contracting Officer’s Representative for purchased care, and a Department of Veterans Affairs physician or pharmacist. Also attending each meeting are invited, non-voting guests from within DOD and/or other Federal Agencies such as Indian Health Services, the Centers for Disease Control, Immigration and Customs Enforcement, etc. to support the analysis and discussion that ultimately lead to the DOD P&T Committee’s final recommendations.

The DOD P&T Committee is part of a larger drug review and placement process. While members can do their own research or the Committee can seek consults from other experts, they are fundamentally supported by the work of the DHA Formulary Branch with initial literature reviews, digestion of clinical trial data, and cost-effective analyses. The DOD P&T Committee’s recommendations are not the final decision. The Beneficiary Advisory Panel (BAP) reviews and comments on the DOD P&T Committee’s recommendations before final decision is issued by the DHA Director.

The direct link between formulary placement and a patient’s access to a product highlights the pivotal role the DOD P&T Committee plays in determining which medications will be available to military beneficiaries. Pharmaceutical manufacturers have an opportunity to improve a product’s access by actively participating in the DHA solicitation process, which includes both a technical and cost element.