Compound Drugs

Compound drugs are:

  • A combination of two or more drugs
  • Prepared by a pharmacist
  • For a patient’s individual needs

Screening Process for Compound Drugs

Step 1: Electronic Screen

Express Scripts screens each ingredient to make sure:

  • TRICARE covers it.
  • It’s safe and effective.
  • It’s medically necessary.

This step usually takes less than five seconds to complete.

Step 2: Required if the Compound Doesn’t Pass Step 1

If the compound drug—or any ingredient in it—doesn’t pass the first step, your pharmacist can:

  • Remove the non-covered ingredient or replace it with a covered ingredient.
  • Contact your doctor to request a different drug to treat your condition.

This step happens while you wait at the pharmacy. It may take 15 to 20 minutes.

Step 3: Prior Authorization

Your doctor can request prior authorization for the compound drug if they can’t substitute an ingredient or prescribe a different drug for you. This allows Express Scripts to individually review your prescription to make sure it’s safe, effective, and .

To request prior authorization:

This step usually takes about five days from when Express Scripts gets all the necessary paperwork.

If your compound drug doesn’t get approved, you have 90 days to request a formal appeal.

Last Updated 6/15/2026