Sponsor
Mariannette Miller-Meeks
Representative · R-IA
Representative · R-IA
The bill centralizes and standardizes VA drug purchasing and formulary decisions to lower costs and improve efficiency and clinical oversight, but those gains come with risks of reduced access to some medicines, higher costs for non‑preferred drugs, added administrative burden, and less price transparency.
Veterans will likely pay less for many medications because the VA can negotiate supplemental discounts, preferencing deals, value‑based contracts, and lower 30‑day copays for generics and national‑formulary drugs.
Veterans will face a clearer, standardized national formulary and more consistent prescribing and procurement practices, improving predictable access to covered medications and reducing wasteful variation.
Veterans may see better clinical outcomes because preferred‑status agreements must be clinically appropriate and the bill adds monitoring, value‑based contract evaluations, and more frequent review cadence to assess effectiveness.
Veterans could lose coverage or have access restricted if codifying or changing the formulary removes drugs they currently receive or if manufacturers refuse preferred deals and drugs are moved off‑formulary.
Veterans who need brand‑name or non‑formulary drugs will face higher 30‑day copayments, raising out‑of‑pocket costs for those patients.
Implementing negotiations, value‑based contracts, enhanced monitoring, and a new advisory process will impose administrative and implementation costs that could divert VA resources or require new funding and staffing.
Based on analysis of 4 sections of legislative text.
Establishes statutory VA national formulary authority, allows negotiated discounts/value‑based contracts, requires reviews and reporting, and tiers copayments favoring generics/formulary drugs.
Official title: To amend title 38, United States Code, to make certain improvements in the administration of the national formulary of the Department of Veterans Affairs, and for other purposes.
Introduced December 10, 2025 by Mariannette Miller-Meeks · Last progress December 10, 2025
Creates a statutory framework for a Department of Veterans Affairs national drug formulary, authorizes the VA to negotiate supplemental discounts and value‑based purchasing arrangements with drug and biologic manufacturers, and updates veteran copayments to favor generics and national formulary drugs. It also requires outcome and budgetary reviews of major formulary actions and establishes a short‑term Veterans Formulary Advisory Committee to provide veteran and clinician input on formulary decisions. The bill codifies the national formulary into title 38 U.S.C., preserves existing statutory price limits, directs use of industry best purchasing practices when practicable, mandates reporting to Veterans’ Affairs committees after reviews, and sets a two‑year termination for the advisory committee.