# Impact of the VA Medication Copayment Redesign

> **NIH VA I01** · EDWARD HINES JR VA HOSPITAL · 2020 · —

## Abstract

Project background/rationale: Veterans using Department of Veterans Affairs (VA) healthcare
facilities tend to have more chronic diseases than the general population, which frequently
require chronic pharmacologic treatment. Appropriate medication management is important to
prevent untoward health effects for these Veterans. VA's current policies may result in
copayments that are higher in VA for certain medications than in non-VA retail pharmacies,
which could encourage use of non-VA pharmacies. Having medication records across more
than one healthcare system increases the risk that records will be incomplete, which can lead to
unintended adverse reactions. Additionally, medication copayments may be associated with
reduced medication adherence. Consequently, VA will change to a 3-tiered system in February
2017 ($5, $8, and $11 per 30-day supply for Tier 1, 2 and 3 medications, respectively), and
there will be a cap on annual medication copayments that Veterans have to pay of $700. The
VA anticipates that for most Veterans, these new copayment amounts will result in lower out-of-
pocket costs, which will encourage greater adherence to prescribed medications and will reduce
the risk of fragmented care that results when Veterans use multiple pharmacies. Understanding
the impact of the copayment change will be crucial for policymaking and planning.
Project objectives: The aims of this study are to 1) determine the impact of the copayment
change on patient use of VA pharmacies; 2) examine the impact of the copayment change on
patient medication adherence, medication costs, and clinical outcomes; 3) assess the impact of
the copayment change on patient-reported medication management experiences; and 4) assess
the impact of the copayment change on provider-reported prescribing practices and
experiences.
Project methods: We will use a mixed methods approach that takes maximum advantage of
available data from VA to examine whether the copayment change impacted receipt of
medications from VA pharmacies (Aim 1), medication adherence (Aim 2), and Veteran and
provider experiences and decision making (Aims 3 and 4). Because the implications of the
copayment restructuring will depend on Veterans' decision making (e.g., where to obtain
medications) and on providers' prescribing practices (e.g., whether they switch patients to Tier 1
medications), we will conduct surveys and semi-structured interviews to examine patient and
provider experiences with the copayment change and its implementation.

## Key facts

- **NIH application ID:** 9673615
- **Project number:** 5I01HX002331-02
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** Kevin T. Stroupe
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-04-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9673615

## Citation

> US National Institutes of Health, RePORTER application 9673615, Impact of the VA Medication Copayment Redesign (5I01HX002331-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9673615. Licensed CC0.

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