Sponsors
The bill codifies and reforms the VA national formulary to pursue lower drug prices, value‑based purchasing, and stakeholder input—potentially saving money and improving outcomes for many veterans while risking reduced access or higher costs for some patients, added administrative burdens, and limited influence from a small, time‑limited advisory committee.
Veterans and taxpayers: VA can negotiate discounts/rebates, use tiered copayments, and employ flexible procurement (volume/blanket purchases), likely lowering VA drug spending and reducing out‑of‑pocket costs for many veterans.
Veterans with chronic conditions: VA may enter value‑based contracts tying payment to drug effectiveness, which could improve clinical outcomes and align spending with real-world benefits.
Veterans and front‑line clinicians: The bill requires VA to consider veteran and clinician perspectives in formulary reviews, which should improve medication appropriateness and reduce disruptive or harmful prescribing changes.
Veterans and patients with chronic conditions: Preferred‑status agreements could limit access to non‑preferred or non‑formulary drugs and force therapy switches, risking worse clinical outcomes for some individuals.
Veterans: Tiered copayments and higher costs for brand‑name or non‑formulary drugs could raise out‑of‑pocket spending for those who need medicines not favored by the formulary.
Taxpayers, state governments, and health systems: Implementing value‑based contracts, collecting outcomes data, updating statutes, and staffing the advisory committee will increase administrative burdens and implementation costs.
Based on analysis of 4 sections of legislative text.
Introduced December 10, 2025 by Mariannette Miller-Meeks · Last progress December 10, 2025
Creates a statutory home for a Department of Veterans Affairs (VA) national drug formulary, gives the VA new authority to negotiate supplemental discounts and value‑based purchasing (VBP) for drugs and biologics, and requires the VA to adopt a tiered copayment schedule that charges lower copays for 30‑day supplies of generics or formulary drugs than for brand‑name or non‑formulary drugs. It also establishes a temporary Veterans Formulary Advisory Committee to provide veteran and clinician input on proposed formulary changes and requires outcome and cost‑effectiveness evaluations with reports to congressional veterans’ affairs committees. The bill focuses on procurement flexibility and price‑leveraging tools for the VA, introduces specific reporting deadlines (180 days and one year) for evaluations and congressional reports, and makes several clerical codification changes to place the formulary in title 38 of U.S. law. The advisory committee is advisory only, limited to ten members, must meet at least semiannually, and sunsets two years after creation.