Prescription drugs received through the Department of Veterans Affairs for non-service connected conditions could cost many veterans less under a new rule that kicks in Feb. 27.
Currently, the VA charges veterans who do not qualify for free health care $8 or $9 for a 30-day or less drug supply, depending on their category. Those costs were set to increase over time based on a Medical Consumer Price Index calculation.
The new plan, however, will categorize drugs into tiers, similar to how medication is handled by Tricare. Tier 1 medications, described as "preferred generics," will cost $5 for a 30-day or less supply. Tier 2, or "non-preferred generics," will cost $8 for a 30-day or less supply. Tier 3, or "brand name," will cost $11 for a 30-day or less supply.
Officials estimate that most users will see a 10 to 50 percent reduction in the cost of the drugs they receive from the VA, according to the rule proposal posted to the federal register early this year.
"By our estimate, 94 percent of co-payment eligible veterans would experience no cost increase, and 80 percent would realize a savings of between $1 and $5 per 30-day equivalent of medications," the proposal states.
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 musculoskeletal conditions, antihistamines and steroid-containing generics would not because they are typically used on an "as-needed basis," the document says.
"VA estimates that at least 50 percent of all billable prescriptions would be in Tier 1, with no more than 35 percent in Tier 2, and approximately 15 percent in Tier 3," the rule proposal states.
The annual drug co-payment cap for veterans in priority groups two through seven is $700.
Veterans who meet certain qualifications, including a disability rating above 50 percent or who qualify as low-income, can receive free health care from the VA and are not subject to the co-pay costs.
This article has been edited to reflect the correct date the price change begins after a document provided by the VA cited an incorrect start date. The correct date is Feb. 27.
-- Amy Bushatz can be reached at amy.bushatz@military.com.
