Office of Research & Development |
  |
Talk to the Veterans Crisis Line now
An official website of the United States government
VA Research Currents archive
Posted September 13, 2013
(VA Research Currents; online only)
Veteran Ron Deluca receives a prescription from pharmacy technician Patrick Malloy at the VA Pittsburgh Healthcare System. A study found that VA's nationwide pharmacy system achieves huge cost-savings, relative to Medicare, by taking better advantage of generic drugs. (Photo by Bill George)
Medicare beneficiaries with diabetes are two to three times more likely to use expensive brand-name drugs than a comparable group of VA patients, according to a nationwide study by researchers with VA, the University of Pittsburgh, and Dartmouth College.
Spending in Medicare Part D would have been an estimated $1.4 billion less in 2008 if brand-name and generic drug use matched that of VA for the medications studied. Conversely, VA would have spent an additional $108 million if it had followed Medicare practices.
The report is the first large-scale comparison of prescription drug use between Medicare Part D and VA. VA administers its own prescription benefits and has a single national formulary, while Medicare contracts with more than 1,000 private insurance companies, each with its own formulary and cost-sharing arrangement.
"Our study shows that we can make a big dent in Medicare spending simply by changing the kinds of medications people are using—and physicians are prescribing—without worrying about whether the government should or should not negotiate drug prices," said lead author Walid Gellad, MD, MPH. "The levels of generic use found in the VA are attainable, and they are compatible with high-quality care." Gellad is an assistant professor at Pitt and a researcher at VA�s Center for Health Equity Research and Promotion.
The team analyzed 2008 data for more than one million Medicare beneficiaries and more than 500,000 older Veterans to compare prescription use between Medicare and the VA. They focused on medications for diabetes, cholesterol, and high blood pressure.
The study was funded by VA, the National Institutes of Health , and the Robert Wood Johnson Foundation .
(Annals of Internal Medicine, online June 11, 2013)