Summary: All pharmacies run by the Department of Veterans Affairs (VA) provide medications and medical supplies that are available over the counter through other local outlets. The most frequently dispensed over-the-counter products include (1) medications, such as aspirin and insulin; (2) dietary supplements, including Sustacal and Ensure; and (3) medical supplies, such as alcohol prep pads, lancets, and glucose test strips. Unlike VA, public and private health plans cover few, if any, over-the-counter products for their beneficiaries. VA pharmacies dispensed over-the-counter products more than 15 million times during fiscal year 1995 at an estimated cost of $165 million, including handling costs of $48 million. VA recovered about $7 million through veterans' copayments, or about four percent of its total over-the-counter costs. Although many veterans shared a modest portion of the costs and some paid the full amount, most veterans paid nothing. GAO suggests several ways that VA could cut costs associated with dispensing over-the-counter products or boost revenues from copayments. First, VA could more narrowly define when to provide over-the-counter products. Second, VA could more efficiently dispense over-the-counter products and collect copayments. Third, VA facilities could further reduce the number of over-the-counter products available to veterans on an outpatient basis. Finally, Congress could expand copayment requirements.
