Access to Affordable Medications: The Department of Veterans Affairs Pharmacy Plan as a National Model

In 1995, the Department of Veterans Affairs (VA) established its Pharmacy Benefits Management Strategic Healthcare Group (PBM-SHG) to provide an integrated, comprehensive, portable, high-quality national drug plan for veterans. In the 12 years since then, PBM-SHG has matured into a pharmacy plan that has garnered national and international attention for maintaining a generous drug benefit at a very low cost. Indeed, the success of the VA’s pharmacy benefit plan has led many to suggest that it be a model for other integrated pharmacy plans, including Medicare Part D. The success of the VA prescription drug program has also been a concern for some, resulting in critical publications in the lay press, at times with misleading information. We describe the VA’s pharmacy benefit and outline some of the strategies that have helped the organization achieve a high-quality benefit while keeping pharmacy costs at a level that is almost certainly the lowest in the United States.