Veterans Using VA Pharmacy Services are More Ill than their Counterparts
As prescription drug use and expenditures have risen dramatically over time, it is important to focus on Veterans who may come to VA primarily to take advantage of the pharmacy benefit. VA provides a comprehensive prescription drug program designed to address the medication needs of Veterans, while maintaining low costs, with most Veterans paying $8 for a 30-day supply of each medication. This study compared users and non-users of VA pharmacy services separately by age group - Veterans ages 18-64 (non-elderly) vs. age 65 and older (elderly). Using data from the Medical Expenditure Panel Survey (MEPS), which measures all healthcare service use inside and outside of VA, investigators pooled data from 2003 through 2005. [MEPS is sponsored by the Agency for Healthcare Research and Quality.] For this study, VA pharmacy services "users" included Veterans who had at least one VA pharmacy claim and used other VA healthcare services at least once (533 non-elderly and 638 elderly); "non-users" included Veterans who had at least one non-VA pharmacy claim and used non-VA healthcare services at least once (1,555 non-elderly and 1,428 elderly).
Findings suggest that Veterans who use VA pharmacy services appear to be more ill than their counterparts who do not use the VA pharmacy benefit. Among younger Veterans, users of the VA pharmacy were more than twice as likely to report fair or poor general health status (53.5% vs. 21.4%) and more than three times as likely to report fair or poor mental health status (32.1% vs. 10.2%). Moreover, both non-elderly and elderly users of VA pharmacy services reported more medical conditions and were more disabled. Overall results show a higher proportion of Veterans who use VA pharmacy services are African American and have no alternative insurance. Compared to non-users, VA pharmacy users also were more likely to be unemployed or out of the labor force (47.7% vs. 19.8%), and living in a poor or low income family (32.4% vs. 11.5%). Results of this study are valuable when comparing VA's national drug plan to other models of prescription drug coverage because patient characteristics will influence the types of medications included in the plans, as well as their level of use.
Aspinall S, Banthin J, Good C, Miller G, and Cunningham F. VA pharmacy users: How they differ from other Veterans. American Journal of Managed Care October 2009;15(10):701-708.
Drs. Aspinall and Good are part of HSR&D's Center for Health Equity Research and Promotion.