Association of VA Medication Copayment Restructuring With Pharmacy Use, Medication Costs, and Financial Burden of Medications
In February 2017, the Department of Veterans Affairs (VA) restructured outpatient medication copayments, creating three medication tiers comparable with private-sector value-based insurance designs (with copayments: US$5, US$8, US$11 per 30-day supply for Tiers 1-3, respectively); however, Veteran medication management experiences have not been assessed following this change. We invited a random sample of Veterans with chronic conditions (e.g., diabetes, hypertension) who utilized VA services to complete a mailed survey about VA and non-VA pharmacy use and medication management experiences following this restructuring. There were 2,884 respondents (29% response rate). Veterans with the lowest proportion of medications from Tier 1 after the restructuring had the highest predicted probability of non-VA pharmacy use from regression analyses. Among respondents subject to VA copayments, 27% reported being better able to afford medications after the restructuring. However, 29% reported worrying about paying for medications, and 18% reported making tradeoffs (e.g., spending less on utilities, food) to pay for prescriptions.
Authors
- Zhiping Huo (ORCID: https://orcid.org/0000-0002-5652-9726)
- Katie J. Suda
- Beverly González (ORCID: https://orcid.org/0000-0002-3007-5789)
- Francesca Cunningham (ORCID: https://orcid.org/0000-0001-7924-8372)
- Charlesnika Tyon Evans (ORCID: https://orcid.org/0000-0002-0696-8288)
- Talar Markossian (ORCID: https://orcid.org/0000-0002-8147-7083)
- Bridget Smith (ORCID: https://orcid.org/0000-0002-3301-8843)
- Dolores Ippolito
- Ibuola Kale (ORCID: https://orcid.org/0000-0002-0672-3328)
- Muriel Burk (ORCID: https://orcid.org/0009-0005-0278-5918)
- Kevin T. Stroupe (ORCID: https://orcid.org/0000-0001-9735-4929)
- Timothy P. Hogan (ORCID: https://orcid.org/0000-0002-6888-0927)
- Chad Osteen
- Bella Etingen (ORCID: https://orcid.org/0000-0003-1325-9073)
Institutions
- Northwestern University (US)
- United States Department of Veterans Affairs (US)
- Chicago Department of Public Health (US)
- University of Pittsburgh (US)
- Loyola University Chicago (US)
- Veterans Health Administration (US)
- VA Boston Healthcare System (US)
- Edward Hines, Jr. VA Hospital (US)
- Bedford VA Research Corporation (US)
- Canandaigua VA Medical Center (US)
- VA New England Healthcare System (US)
- Southwestern Medical Center (US)
- Medication Management (United States) (US)
- VA Pittsburgh Healthcare System (US)
- Dallas VA Medical Center (US)
- The University of Texas Southwestern Medical Center (US)
Publication Details
- Journal
- Medical Care Research and Review
- Published
- 2025-08-04
- DOI
- https://doi.org/10.1177/10775587251356369
- Primary Topic
- Medication Adherence and Compliance
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- U.S. Department of Veterans Affairs