In July 2024, an article written by our team was accepted by Life Science Leader for publication on its digital platform. Life Science Leader is a widely respected pharmaceutical industry magazine. We appreciated the opportunity to contribute to such an important thought leader with An Updated View Of The Federal Segment: Veterans Affairs Formulary Management published on July 24, 2024.
The purpose of this refresh on how the Veterans Health Administration (VHA) within the Department of Veterans Affairs (VA) manages its formulary was to establish a set of common baseline facts and insights so pharmaceutical manufacturers can view this market segment with fresh eyes and a renewed understanding. Although it is long established that the VHA operates most similarly to a single-payer integrated delivery network (IDN) with a focus exclusively on the needs of our military veterans, it is less understood how the high degree of control over drug access should shape a pharmaceutical manufacturer’s approach and expectations to this segment of the Federal market. The details provided on the centralized, top-down nature of the national formulary management process should clarify for pharmaceutical manufacturers the differences between this market and other high-control IDNs.
One particular highlight of this article is the chart showing the low number of drugs that were approved for full inclusion on the VA formulary versus the number of products with criteria-for-use (CFU) or local-level prior authorizations (PAs). These deeper revelations expertly articulate how both the public-facing national CFUs as well as the internal, local level PAs must be taken into consideration when developing a strategy for a new or existing product. Moreover, this chart better frames for pharmaceutical manufactures what success in this segment potentially looks like through the broader view of these other control nuances.
As of 04/2024 | 2021 | 2022 | 2023 |
New Molecular Entities (NME) FDA Approved | 50 | 37 | 53 |
VA Clinical Guidance Established | 23 | 24 | 13 |
Criteria-for-Use (CFU) Established | 18 | 18 | 11 |
On VA National Formulary | 2 | 7 | 5 |
Prior Authorization (PA) | 2 | 6 | 4 |
For additional published thought-leadership by our consultants see:
An Uncertain Future For Interchangeability, January 1, 2024
Pricing Strategy For New Anti-Alzheimer's Drug Puts Access Community On The Defensive, January 25, 2023
Top 5 Guidelines To Federal Market Success in 2020, April 1, 2020
McKesson's New Deal With The VA - What Pharma Needs To Know, February 4, 2020