VA National Formulary Act of 2025

Uniformity of Care: The national formulary will be implemented uniformly across all Department medical facilities, ensuring consistency in drug availability (Sec. 7385(b)(1)).

Increased Transparency: The Secretary is required to communicate regularly with the public regarding formulary management and provide rationales for significant changes, such as removing a commonly used medication (Sec. 7385(c)).

Efficient Drug Access: The establishment of a standardized electronic system for nonformulary requests aims to integrate with clinician workflows for faster service (Sec. 7387(a)).

Prompt Clinical Decisions: The bill mandates that initial decisions on nonformulary drug requests be communicated to clinicians within 96 hours (Sec. 7387(b)).

Portability of Approvals: If a drug is approved for a veteran, that approval remains valid even if the veteran moves to a different medical center or location within the Veterans Health Administration (Sec. 7387(d)).

Enhanced Safety: The bill requires medication therapy management with a focus on polypharmacy and high-risk medications to identify inappropriate prescribing or drug duplication (Sec. 7388(b)).

Cost Savings through Negotiation: The Secretary is authorized to negotiate additional discounts, rebates, and value-based agreements with manufacturers to provide net cost savings (Sec. 8130(a) and (b)).

Veteran Input: The creation of a Veterans Formulary Advisory Committee allows front-line providers and stakeholders to provide feedback on proposed changes (Sec. 4(a) and (d)).

Local Formulary Restrictions: Individual medical centers or networks are generally prohibited from maintaining a local formulary that includes drugs not found on the national list (Sec. 7385(b)(2)).

Increased Costs for Certain Medications: A tiered copayment schedule will result in higher copayments for brand-name drugs or drugs not included on the national formulary (Sec. 1722A(d)(2)).

Potential Access Barriers: While waivers exist, the bill restricts the ability of local facilities to carry drugs that are not part of the national formulary unless specifically approved through a centralized review process (Sec. 7385(b)(2)).