VA Announces Drug Price Reductions at February’s End

The Department of Veterans Affairs (VA) is amending its regulation on co-payments for Veterans’ outpatient medications for non-service connected conditions.

The VA currently charges veterans who do not qualify for free health care either $8 or $9 for a 30-day or less drug supply.

But under a new plan set to kick in February 27th, the VA will categorize drugs into tiers, with tier 1 medications (preferred generics) costing $5, and tier 2 (non-preferred generics) costing $8 for a 30-day or less supply. Tier 3 (brand name) will cost $11 for a 30-day or less supply.

Most veterans will see a 10 to 50 percent reduction in the cost of the drugs they receive from the VA.

“Switching to a tiered system continues to keep outpatient medication costs low for Veterans,” said VA Under Secretary for Health Dr. David J. Shulkin. “Reducing their out-of-pocket costs encourages greater adherence to prescribed outpatient medications and reduces the risk of fragmented care that results when multiple pharmacies are used; another way that VA is providing better service to Veterans.”

A series of seven criteria is used by the VA to determine which generic drugs are on the lower-cost “preferred generics” list, and which drugs are “non-preferred generics” and cost $3 more per 30-day or less supply, according to the rule proposal.

For example, generic drugs typically used to treat a common “chronic condition,” such as hypertension, will be on the list, while topical creams, products used to treat musculo-skeletal conditions, antihistamines and steroid-containing generics would not because they are typically used on an “as-needed basis,” the document says.

Co-payments stop each calendar year for Veterans in Priority Groups 2-8 once a $700 cap is reached.

These changes apply to Veterans without a service-connected condition, or Veterans with a disability rated less than 50 percent who are receiving outpatient treatment for a non-service connected condition, and whose annual income exceeds the limit set by law. Medication co-payments do not apply to former Prisoners of War, catastrophically disabled Veterans, or those covered by other exceptions as set by law.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Mitalis

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