# Tiered Pharmacy Copayments for Medications Update
**AGENCY:**
Department of Veterans Affairs.
**ACTION:**
Notice.
**SUMMARY:**
This Department of Veterans Affairs (VA) notice updates the information on Tier 1 medications.
**FOR FURTHER INFORMATION CONTACT:**
Joseph Duran, Office of Community Care (10D), Veterans Health Administration (VHA), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, *[email protected],* (303) 372-4629 (this is not a toll free number).
**SUPPLEMENTARY INFORMATION:**
Section 17.110 of Title 38, Code of Federal Regulations, governs copayments for medications that VA provides to veterans. Section 17.110 provides the methodologies for establishing the copayment amount for each 30-day or less supply of medication provided by VA on an outpatient basis (other than medication administered during treatment). “Tier 1 medication means a multi-source medication that has been identified using the process described in paragraph (b)(2) of this section.”
Section 17.110 provides that a list of Tier 1 medications will either be published as a notice in the *Federal Register* or will be posted on VA's website at *www.va.gov/health* at least once per year.
Based on the methodologies set forth in § 17.110, this notice updates the list of Tier 1 medications. Not less than once per year, VA will identify a subset of multi-source medications as Tier 1 medications. Only medications that meet all of the criteria in paragraphs (b)(2)(i), (ii), and (iii) will be eligible to be considered Tier 1 medications, and only those medications that meet all of the criteria in paragraph (b)(2)(i) of this section will be assessed using the criteria in paragraphs (b)(2)(ii) and (iii). As of the date of this notice, the Tier 1 medication list at individual VA medical facilities based on the methodologies in § 17.110 will be posted on VA's website at *www.va.gov/health* under the heading “Tier 1 Copay Medication List.”
The following table is the Tier 1 Copay Medication List that is effective January 1, 2018, and will remain in effect until December 31, 2018.
| Condition | VA product name |
| --- | --- |
| Arthritis & Pain | Aspirin buffered tablet. |
| | Aspirin enteric coated tablet. |
| | Diclofenac Sodium EC tablet. |
| | Meloxicam tablet. |
| Blood Thinners & Platelet Inhibitors. | Clopidogrel Bisulfate tablet. |
| Bone Health | Alendronate tablet. |
| Cholesterol | Atorvastatin tablet. |
| | Lovastatin tablet. |
| | Pravastatin tablet. |
| Dementia | Donepezil tablet. |
| Diabetes | Glipizide tablet. |
| | Metformin HCL 24hr (SA) tablet. |
| Electrolyte Supplement | Potassium SA tablet. |
| Gastrointestinal Health | Omeprazole EC capsule. |
| | Ranitidine tablet. |
| Glaucoma & Eye Care | Brimonidine 0.2% solution. |
| | Latanoprost 0.005% solution. |
| Heart Health & Blood Pressure | Amlodipine tablet. |
| | Atenolol tablet. |
| | Chlorthalidone tablet. |
| | Digoxin tablet. |
| | Diltiazem HCL tablet. |
| | Furosemide tablet. |
| | Hydrochlorothiazide tablet/capsule. |
| | Hydrochlorothiazide/Triamterene cap/tab. |
| | Lisinopril tablet. |
| | Metoprolol Succinate SA tablet. |
| | Nifedipine SA capsule. |
| | Prazosin HCL capsule. |
| | Spironolactone tablet. |
| | Verapamil HCL tablet. |
| Mental Health | Bupropion HCL tablet. |
| | Bupropion HCL SA (24HR-XL) tablet. |
| | Citalopram Hydrobromide tablet. |
| | Escitalopram Oxalate tablet. |
| | Mirtazapine tablet. |
| | Quetiapine Fumarate tablet. |
| | Risperidone tablet, disintegrating. |
| | Trazodone tablet. |
| | Venlafaxine HCL SA tablet/cap. |
| Parkinson Diseases/Restless Legs Syndrome | Carbidopa/Levodopa tablet. |
| Seizures | Gabapentin capsule. |
| | Topiramate tablet. |
| Thyroid Conditions | Levothyroxine Sodium tablet. |
| Urologic (Bladder & Prostate) Health. | Alfuzosin HCL SA tablet. |
| | Finasteride tablet. |
| | Oxybutynin Chloride SA tablet. |
| | Terazosin HCL capsule. |
**Signing Authority**
The Secretary of Veterans Affairs, or designee, approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Gina S. Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, approved this document on February 12, 2018, for publication.
Dated: February 12, 2018.
Jeffrey Martin,
Impact Analyst, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs.