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The Department of Veterans Affairs PACT Act Implementation is a Major Market Event

For some pharmaceutical manufacturers, a major market event in the Federal market has happened and an updated Federal Market Landscape should be completed. When originally signed into law in August of 2022, the implementation of Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (also referred to as the PACT Act) was expected to follow the law’s stated roll-out schedule with full implementation occurring by 2032. Congress allowed for this gradual, multi-year, phased-in approach due to the expected increase in VA healthcare enrollment; however, the Department of Veterans Affairs (VA) took a proactive approach and millions of veterans now qualify to receive VA healthcare services immediately.


The purpose of this legislation was to expand healthcare benefits to veterans who experienced negative health consequences due to toxic exposures during their time in service to our country both domestically (i.e., during training, from contaminated water at Camp LeJeune, etc.) and during international deployment (e.g., from burn pits, due to Agent Orange, etc.). Three key provisions of this law include (1) inclusion of a presumptive list of service-connected conditions, (2) substantial increase in allocated resources for veterans with these exposures, and (3) improved screening for presumptive illnesses.


Veterans do not automatically receive VA healthcare benefits. While any veteran can apply for and be determined eligible to receive healthcare through the VA based on qualifying criteria including service length and discharge status, veterans seeking service-connected disability status must typically prove a direct connection that their medical condition began or worsened during their time in service. In a substantial break from this typical procedure, the PACT Act shifts the burden of proof away from the veteran by establishing a list of presumptive illnesses that are assumed to be service-connected. With a presumptive condition, veterans who receive a diagnosis from the included list of illnesses (from cancer to respiratory illnesses) do not need to prove a direct link between their time in service and the illness.  A veteran can now qualify for medical, financial, and other types of support simply through their military record showing service in a designated location during a specific timeframe and a diagnosis with one of the presumptive conditions.


It is well established that early detection, diagnosis, and treatment are key to improving health outcomes. The VA is providing faster access through this new process by allowing veterans to seek care within a system dedicated to the unique needs of veterans sooner. The PACT Act requires a proactive approach to identifying veterans with potential toxic exposure through enhanced screenings. Generally, a veteran’s primary care physician will perform the toxic exposure screening and, if appropriate, connect the veteran to other specialists for care. Because the VA is focused specifically on the needs of veterans, it is generally better equipped to handle treatment for illness resulting from the toxic exposure.

This accelerated access to the VA healthcare system, years earlier than required by the law, represents a significant market event for pharmaceutical manufacturers offering life-saving and/or life-extending treatment options for the conditions included on the list of presumptive illnesses. The expected substantial increases in the Federal market patient population means a manufacturer should best prepare now to meaningfully serve our nation’s veterans.


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