title: Medication acquisition by veterans dually eligible for Veterans Affairs and Medicare Part D pharmacy benefits.
abstract: The patterns of medication acquisition for veterans dually eligible for pharmacy benefits from the Department of Veterans Affairs (VA) and Medicare Part D-reimbursed pharmacies were examined.
  
  
  
  The characteristics of veterans who used pharmacies reimbursed by (1) VA only, (2) both VA and Part D-reimbursed, and (3) Part D-reimbursed only pharmacies in 2009 were compared and their medication types and sources examined. Pharmacy usage was measured as the number of 30-day medication supplies and the number of different drug classes that veterans received from VA and Part D-reimbursed pharmacies. Chi-square testing and analysis of variance were used to compare unadjusted patient characteristics and healthcare utilization.
  
  
  
  A total of 145,899 veterans with any VA or Part D-reimbursed pharmacy use were included in the study: 69.6% used VA pharmacies only, 9.9% used VA and Part D-reimbursed pharmacies, and 20.5% used Part D-reimbursed pharmacies only. Veterans who lived in rural areas, were non-Black, had VA medication copayments, or were dual or Medicare-only outpatient users were more likely to be dual or Part D-reimbursed only pharmacy users (p < 0.001). Dual pharmacy users received more 30-day supplies than did the other two pharmacy-use groups (p < 0.001).
  
  
  
  Nearly one third of VA users received medications from Part D-reimbursed pharmacies, either alone or together with VA pharmacies. Among dual pharmacy users, over half received medications from the same drug class from both VA and Part D-reimbursed pharmacies for which the days' supplies overlapped by more than seven days.
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL kevin.stroupe@va.gov.|Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL. kevin.stroupe@va.gov.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.|Smith Child Health Research Program, Stanley Manne Children's Research Institute, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.|Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bailey
authors.affiliation: Stritch School of Medicine, Loyola University Chicago, Maywood, IL.
authors.forename: Jamal
authors.initials: J
authors.lastname: Adas
authors.affiliation: Center for Health Equity Research and Promotion, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, PA.|University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Walid F
authors.initials: WF
authors.lastname: Gellad
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.|Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL.
authors.forename: Katie
authors.initials: K
authors.lastname: Suda
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Huo
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
authors.forename: Sean
authors.initials: S
authors.lastname: Tully
authors.affiliation: Veterans Administration Pharmacy Benefit Management Services, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
authors.forename: Muriel
authors.initials: M
authors.lastname: Burk
authors.affiliation: Veterans Administration Pharmacy Benefit Management Services, Edward Hines Jr. Veterans Administration Hospital, Hines, IL.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cunningham
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data*; D010593:Pharmaceutical Services / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000627:therapeutic use*; D012051:Reimbursement Mechanisms; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D055553:Prescription Drugs
keywords: Medicare; pharmacy benefits; pharmacy services; utilization; veterans