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The Honolulu Advertiser
Posted on: Monday, December 11, 2006

Veterans now may purchase drugs from low-cost retailers

By Dennis Camire
Advertiser Washington Bureau

WASHINGTON — Wal-Mart has been known to set pricing trends in the retail industry, but this time it seems to have influenced the way the government provides prescription drugs to the nation's military veterans.

When the retailing giant rolled out $4 pricing on generic drugs in September, first in Florida, and in Hawai'i by late November, it caught the eye of some of the 2.6 million veterans who pay $8 per prescription to the Veterans Affairs Department.

At first, the government agency told veterans they couldn't take their prescriptions to Wal-Mart or other outside pharmacies, because the prescriptions were written specifically for VA pharmacies.

But after some veterans asked to use the low-cost retailers, the VA started changing the rules, allowing VA doctors to more easily write prescriptions that could be filled at outside pharmacies.

New guidelines issued last month allow veterans to save money by going to Wal-Mart, Target, Costco and other stores that have started low-price generic programs, according to Michael Valentino, chief consultant for pharmacy benefits management in the VA.

"Veterans are price sensitive like everyone else," Valentino said. "We try to accommodate not only their medical needs but also their economic desires."

The change in policy apparently is not widely known yet among veterans who use the VA medical system, according to several veterans' groups.

Fred Ballard, spokesman for the VA Pacific Islands Health Care System, said a survey of the VA doctors found that no one has requested an outside prescription in Hawai'i, where Wal-Mart began its program on Nov. 27.

"They (doctors) have the instructions on what to do if someone should, but so far, there have been no questions or requests for transfer," he said.

About 2.6 million of the 4.3 million veterans who received drugs from the VA last year were required to make the $8 payments. Generally, veterans don't qualify for free drugs because their medical conditions are not service-related or they have too much income.

Valentino said he does not know how many veterans are interested in going to outside pharmacies.

"We really don't have hard numbers, but it's more than a few," he said. "We have a lot of anecdotal information."

Veterans welcomed the new rules. "I go along with that," said Gerald Yohman, 71, a Korean War veteran in Apollo Beach, Fla. "I got six prescriptions, so I spend about $150 every three months (at the VA). Looks like it might cut my costs in half, if I can get the prescriptions."

The VA also is looking for ways to reduce veterans' co-payments for generic drugs at its pharmacies, but no deadline has been set for any action.

Joey Ilem, a legislative director for Disabled American Veterans, said that one concern about letting VA patients fill prescriptions outside the agency is that it could present problems in monitoring their drug intake and interactions.

Now, when veterans go to a VA medical facility, doctors see records of their prescriptions having been filled. But records from outside pharmacies won't show up.

"Whenever you start to break up that care ... you lose a little bit of control in terms of the person taking his medication and being monitored," she said.

Joe Davis, spokesman for Veterans of Foreign Wars, said the low-priced generic drugs was a good thing for all Americans, but he wanted to know why the VA couldn't follow suit.

"We know that Wal-Mart is doing this as a loss leader to get people into their stores. It makes sense," he said. "Well, if they can do that, why can't the VA, because the VA is the largest healthcare system in the country."

As for Wal-Mart, officials there said the generic drug program is proving very popular, increasing prescriptions by 2.1 million across the first 27 states to get the program in an initial six-week period, compared with the same period last year. The Bentonville, Ark., company won't say how many prescriptions it fills, company spokesman Jami Arms said.

Reach Dennis Camire at dcamire@gns.gannett.com.