# Helping Veterans Navigate Dual Pharmacy Benefits

> **NIH VA IK2** · DURHAM VA MEDICAL CENTER · 2022 · —

## Abstract

Background: Nearly 30% of Veterans with diabetes dually use Medicare Part D and VA to fill
their antidiabetic medications, and dual users have poorer glycemic control and poorer
medication adherence than Veterans who fill only through VA. Yet few resources exist to help
Veterans understand and navigate between these dual pharmacy benefits.
Significance/Impact: The goal of this research is to understand how Veterans are choosing
between VA and Part D, identify knowledge gaps, and rigorously develop and test an
intervention that will educate and optimize Veteran choice on prescription coverage.
Innovation: This research is innovative because it: i) uses a stated-preference research
method, called a discrete choice experiment, to quantify Veteran preferences when choosing
which pharmacy benefit through which to fill their antidiabetic medications and ii) rigorously
develops the first Veteran-facing decision aid that helps improve Veteran decision-making about
where to fill their medication. By applying a Veteran-centered intervention focused on access to
care and health care value to an aging population with a costly and prevalent condition, this
proposal aligns with strategic goals for HSR&D, PBM, and VA in general.
Specific Aims: The specific aims of the CDA-2 proposal are: 1) Identify medication acquisition
challenges and informational needs that Part D-enrolled Veterans have when filling antidiabetic
medications through VA or Medicare Part D; 2) Estimate how Veteran preferences around
aspects such as prescription coverage, travel time, wait time, medication copay, and chance of
adverse events influence where Part D-enrolled Veterans choose to fill antidiabetic medications;
3) Develop and assess feasibility and acceptability of a decision aid that helps Part D-enrolled
Veterans comprehend VA and Medicare Part D prescription benefits to optimize choice on
where to fill medications; and 4) Evaluate how dual use of VA and Part D to fill antidiabetic
medications affects medication expenditures for Veterans, Medicare, and VA.
Methodology: The proposed research consists of four projects, all focused on Part D-enrolled
Veterans using antidiabetic medications. Project 1 is a qualitative study to identify knowledge
gaps and other medication acquisition barriers that Veterans experience when filling
medications through Part D versus VA. Project 1 will comprise of 24 interviews with Part D-
enrolled Veterans with type 2 diabetes, and 12 interviews with caregivers. Project 2 consists of
a discrete choice experiment study that estimates how Veterans trade off between different
aspects such as prescription coverage, travel time, wait time, medication copay, and chance of
adverse events when they decide where to fill their medications. Project 3 will involve the
development and assessment of feasibility and acceptability of a decision aid based on findings
from Aims 1 and 2. Project 4 will encompass a retrospective cohort study, using VA Corporate
Data Warehous...

## Key facts

- **NIH application ID:** 10423855
- **Project number:** 1IK2HX003359-01A2
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Anna Hung
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10423855

## Citation

> US National Institutes of Health, RePORTER application 10423855, Helping Veterans Navigate Dual Pharmacy Benefits (1IK2HX003359-01A2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10423855. Licensed CC0.

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