Chapter 7 Pharmacy Services

What is VA’s Prescription Benefit?

VA’s Prescription Benefit provides safe, effective, and medically necessary medications to ensure the highest quality care for our nation’s Veterans.

VA’s Drug Formulary

Does VA Maintain a List of Preferred Medications?

Yes. This list of medications is called a drug formulary.  The organization that accredits America’s hospitals requires all health care organizations to develop a list of preferred medications that they keep in stock at all times. Health care organizations prefer formulary medications because they are:

         High quality
         A good value

VA’s National Drug Formulary ensures that Veterans across the country have access to the same medications at all VA facilities.

How Do Enrolled Veterans Know if a Medication is on VA’s National Formulary?

The VA National Formulary lists medications alphabetically by generic name, not by brand name. For instance, Zocor would not be listed for cholesterol. Rather one would look for simvastatin instead. A medication can also be looked up by drug class. For example, using the VA Class Index, one would look for penicillin under antimicrobials. A list of the medications on the VA National Formulary can be found at the Pharmacy Benefit Management (PBM) Website:

Are There Some Drugs on the VA National Formulary That Should Not be Substituted with Another Drug?

Yes. In rare instances, there may be a medication that is not recommended for substitution with another drug. The Do Not Substitute List can be found on the VA PBM Internet site:
Can Enrolled Veterans Receive a Drug That is Not on the VA National Formulary?

Yes. There is a process that permits a VA health care provider to prescribe a “non-formulary” drug if special needs  require it. The process assures that a decision to use a non-formulary drug is based on evidence that the preferred
drug is safe and effective.

Why Doesn’t VA Provide the New Medications Seen on Television?

While some new drugs offer important improvements over older drugs, the new drugs are not always better or safer than older drugs. VA has established a process to review the safety and effectiveness of VA National Formulary medications. This process includes comparing several drugs within the same class (such as the statin class for lowering cholesterol or ACE inhibitors for lowering blood pressure). Only those drugs that prove to be the safest and most-effective and that offer the best value are listed on the National Formulary. If a formulary medication is not appropriate, however, each VA medical center has procedures in place to help identify an alternative, non-formulary

Drug makers heavily promote their new drug through advertising and other publicity. But some new drugs are not studied in large groups of people or over long periods of time. As a result, we cannot always know the safety of these medications. When more is known about the safety and effectiveness of newer medications, VA may consider adding them to the National Formulary.

Non-VA Physicians and Prescriptions

VA will fill non-VA prescriptions for Veterans who are in receipt of Aid and Attendance or Housebound benefits. These Veterans may contact, or have their non-VA physician contact, their local VA facility’s Pharmacy Service for more information.

Otherwise, VA is not authorized to fill prescriptions unless they are written by a VA provider. This ensures that VA is able to provide and track the complete medical care for all Veteran patients. The total medication management for a prescription is the responsibility of the provider who writes that prescription.

If the Veteran is receiving care from a non-VA physician, the VA providers need to know about all of the medications prescription, over-the-counter, and herbal supplements) being taken. The private provider must also be aware of the medical treatment and medications received from VA.

If a non-VA physician has prescribed a medication that is not on the VA National Formulary (that is, a “non-formulary” medication), the VA physician may elect to re-write that prescription for a VA National Formulary medication. If this switch is made, it is because the VA health care provider believes the VA National Formulary drug offers the best safety, effectiveness, and overall value.

If the VA health care provider believes that the VA National Formulary medication should not be prescribed, an alternative will be sought. The VA health care provider may need to contact the non-VA physician to obtain access to medical documents that support using a non-formulary m
Tips for Understanding Your Medication

Always Read Your Prescription Label Carefully

When you receive your medication, make sure that you read the instructions on the prescription label carefully and take your medication exactly as directed. Also, look for any stickers that have been placed on the bottle for additional instructions. These may include whether to take with food, or whether there are any activities to avoid. If you have any questions, contact your pharmacy at the number listed on the label.

Why am I Taking This Medication?

Understanding why you are taking a medication is extremely important. Some medications are given only for a specific period of time (for example, an antibiotic taken for a short time for an infection), while others need to be taken regularly on a long-term basis (for example, diabetes or high blood pressure). If you are not sure why you are taking a medication or for how long you should take it, ask!

How Will I Know Whether the Medication is Working?

Some medications are used to treat something you can feel (pain, allergy symptoms), while others are for conditions that may not have any noticeable symptoms (high blood pressure, high cholesterol). With many conditions, your provider will be able to determine whether your medication is working — by doing a physical exam or procedure, or by checking your lab tests. Whether or not you feel that it is working, do not stop taking your medication or change the dosage without talking to your pharmacist or provider. Otherwise, they will not be able to provide the care you need.

What if I Think My Medication is Causing a Side Effect or a Drug Interaction?

Sometimes, medications prescribed to help treat a certain condition can also cause negative side effects. If you think you are having a side effect to a medication or are experiencing a drug interaction, tell your pharmacist or provider immediately. You can then discuss whether it is something that is tolerable, or whether there is another medication that can be used instead.

Some side effects are mild or go away with continued use, but others can be serious. In certain cases, medications may interact with other drugs, supplements, or food in undesirable ways. Common side effects and drug interactions are generally included in the information that comes with your prescription. If you think you are experiencing a serious side effect, contact your provider immediately or call for emergency medical care.