1028. Access to Pharmacy Services Among Medicare Enrolled Veterans
Robert O Morgan, PhD, Houston Center for Quality of Care and Utilization Studies, Houston VAMC, II Wei, Houston Center for Quality of Care and Utilization Studies, Houston VAMC, DA John,, Houston Center for Quality of Care and Utilization Studies, Houston VAMC, JA Davila, Houston Center for Quality of Care and Utilization Studies, Houston VAMC, MM Byrne, University of Pittsburg, DA Paterniti, University of California, DI Nora Osemene, Texas Southern University, LA Petersen, Houston Center for Quality of Care and Utilization Studies, Houston VAMC

Objectives: We examined the reliance of VA-using veterans on the VA health system versus reliance on other sources (e.g., Medicare HMOs) for their pharmacy care, and how veterans relying on the VA compare to other veterans in out-of-pocket costs and financial barriers to getting medications.

Methods: We surveyed elderly, Medicare enrolled male VA-users (N = 1,258) and VA non-using veterans (no VA use in prior 3 years, N = 828), in six large metropolitan areas (52% response rate). We used contingency table analyses, and logistic and linear regression to examine use of pharmacy services.

Results: Most VA users (56%) considered the VA their primary pharmacy source. Medicare HMO-enrolled VA users or those with supplemental insurance were less likely to be primary VA pharmacy users (p <= 0.001 and <= 0.0001, respectively). Controlling for income, insurance status, race/ethnicity, health status, and metropolitan area, primary VA pharmacy users reported lower total out-of-pocket pharmacy costs than either non-primary VA pharmacy users or VA non-using veterans (p <= .0001), were less likely to delay filling prescriptions because of costs (p <= .0001), and were less likely to cite pharmacy coverage as a reason for joining a Medicare HMO (p <= .0001).

Conclusions: The VA appears to be more effective than other sources of pharmacy benefits in reducing financial barriers and maintaining continuity of pharmacy care.

Impact: The VA maintains access to medications at low cost for eligible veterans. Our findings support using the VA system as a model for a potential federal pharmacy program.