Jump to content

Ask Your VA   Claims Questions | Read Current Posts 
Read VA Disability Claims Articles
 Search | View All Forums | Donate | Blogs | New Users | Rules 

  • homepage-banner-2024.png

  • donate-be-a-hero.png

  • 0

VA's formulary list can compromise Veterans health care.

Rate this question



  • Moderator
Posted (edited)

  My VA docs have explained that they generally must order medications "ON VA"S FORMULARY LIST".  At least one doc informed me that he asked for a waiver (to be able to order the medication I needed which was not on VA's formulary list) and it was denied by VA.   

   "NEW" medicines, just introduced by the pharmacy company, are not automatically put on the approved list, but instead medications have to jump through all VA hoops to get on the formulary list.  Some new medications may not make it through VA hoops, but still be good medications.  

   The result is that VA docs cant order it, and must make the difficult choice of ordering no medication, or a medication the doctor thinks is inferior to the med the Veteran needs because the inferior med is "on the formulary list" while the med the Veteran needs is not.  

This is just plain wrong.  

    Sometimes, "its all about the money boyz" and the Va wont pay for the superior, but more costly medication, which essentially means that if the VA can help Vets, they will do so, if its cheap enough for the VA.  

    I did not make this up, the formulary list is here:



Edited by broncovet
Link to comment
Share on other sites

2 answers to this question

Recommended Posts

  • 0
  • Content Curator/HadIt.com Elder

@broncovet The VA providers do have the ability to request approval for use of meds not currently on the VA formulary, but sometimes it takes numerous requests, requires use of all other appropriate alternatives, and has to have convincing medical justification. I had to go through this around 2008 to get the VA to cover Singulair to treat asthma. It took about 4 tries. He kept having to submit to get the approval continued. When the patent expired in 2012, the generic form became available and the med magically appeared on the VA formulary list...


"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat

Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.


Link to comment
Share on other sites

  • 0
  • Moderator

Yes, Vync, I had at least one doc also try to get me medications "not" on VA's formulary list, by applying for some sort of waiver.  So, you are correct there are some work arounds which "MAY" result in the med you need being eventually approved by VA.  

Often it boils down to waiting, and sometimes still never getting the med you need.  But why should Veterans be put through this red tape, when its not happening with civilian doctors.  

When you need a medication, do you need it now, or would you prefer to wait from six months to 16 years or so  until VA gets around to either granting a waiver, or maybe even gets that drug put on the list?  

I see it that you either need the med now, or you dont need it at all.  

Im just not smart enough to know if/which medications I may need 15 years from now.  I have got my hands full making the money ends meet, without trying to predict what medications I will need to take 2 years from now.  Will it take 2 years?  IDK.  But if the way VA benefits works, is any indication, if I apply for a medication to be on the formulary or a waiver, I may be able to get the prescription filled in year 2041 or so, if Im still alive then, because it took VA around 17 years and multiple appeals to finally get it all fixed.  

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Create New...

Important Information

Guidelines and Terms of Use