[Federal Register Volume 86, Number 41 (Thursday, March 4, 2021)]
[Notices]
[Pages 12788-12790]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-04458]


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DEPARTMENT OF VETERANS AFFAIRS


Tiered Pharmacy Copayments for Medications; Calendar Year 2021 
Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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[[Page 12789]]

SUMMARY: This Department of Veterans Affairs (VA) Notice updates the 
information on Tier 1 medications.

FOR FURTHER INFORMATION CONTACT: Joseph Duran, Office of Community 
Care, Veterans Health Administration, Department of Veterans Affairs, 
810 Vermont Avenue NW, Washington, DC 20420; <a href="/cdn-cgi/l/email-protection#de94b1adbbaeb6f09aabacbfb0ec9ea8bff0b9b1a8"><span class="__cf_email__" data-cfemail="c882a7bbadb8a0e68cbdbaa9a6fa88bea9e6afa7be">[email protected]</span></a>; 303-
370-1637. This is not a toll-free number.

SUPPLEMENTARY INFORMATION: Section 17.110 of title 38, CFR, governs 
copayments for medications that VA provides to veterans. Section 17.110 
provides the methodologies for establishing the copayment amount for 
each 30-day or less supply of medication provided by VA on an 
outpatient basis (other than medication administered during treatment).
    Tier 1 medication means a multi-source medication that has been 
identified using the process described in paragraph (b)(2) of this 
section. Not less than once per year, VA will identify a subset of 
multi-source medications as Tier 1 medications. Only medications that 
meet all of the criteria in 38 CFR 17.110(b)(2)(i), (ii), and (iii) 
will be eligible to be considered Tier 1 medications, and only those 
medications that meet all of the criteria in paragraph (b)(2)(i) of 
this section will be assessed using the criteria in paragraphs 
(b)(2)(ii) and (iii).
    Based on the methodologies set forth in Sec.  17.110, this notice 
updates the list of Tier 1 medications for Calendar Year 2021. The Tier 
1 medication list is posted on VA's Community Care website at the 
following link: https://www.va.gov/COMMUNITYCARE/revenue_ops/copays.asp 
under the heading ``Tier 1 Copay Medication List.''
    The following table is the Tier 1 Copay Medication List that is 
effective January 1, 2021 and will remain in effect until December 31, 
2021.

------------------------------------------------------------------------
             Condition                         VA product name
------------------------------------------------------------------------
Arthritis and Pain................  Aspirin Buffered Tablet.
                                    Aspirin Chewable Tablet.
                                    Aspirin Enteric Coated Tablet.
                                    Allopurinol Tablet.
                                    Celecoxib Capsule.
                                    Diclofenac Tablet.
                                    Ibuprofen Tablet.
                                    Meloxicam Tablet.
                                    Naproxen Tablet.
Blood Thinners and Platelet         Clopidogrel Bisulfate Tablet.
 Inhibitors.
                                    Warfarin Sodium Tablet.
Bone Health.......................  Alendronate Tablet.
Cholesterol.......................  Atorvastatin Tablet.
                                    Ezetimibe Tablet.
                                    Pravastatin Tablet.
                                    Rosuvastatin Calcium Tablet.
                                    Simvastatin Tablet.
Dementia..........................  Donepezil Tablet.
Diabetes..........................  Glimepiride Tablet.
                                    Glipizide Tablet.
                                    Metformin Hydrochloride (HCL)
                                     Tablet.
                                    Metformin HCL 24-Hour Sustained
                                     Action (SA) Tablet.
                                    Pioglitazone HCL Tablet.
Electrolyte Supplement............  Potassium SA Tablet.
                                    Potassium SA dispersible Tablet.
Gastrointestinal Health...........  Famotidine Tablet.
                                    Omeprazole Enteric Coated (EC)
                                     Capsule.
                                    Pantoprazole Sodium EC Capsule.
Glaucoma and Eye Care.............  Diclofenac Solution.
                                    Dorzolamide 2%/Timolol 0.5%
                                     Solution.
                                    Latanoprost 0.005% Solution.
                                    Polyethylene Glycol 400/Polyethylene
                                     Glycol 4000 Solution.
                                    Carboxymethylcellulose Sodium
                                     Solution.
Heart Health and Blood Pressure...  Amlodipine Tablet.
                                    Amiodarone HCL Tablet.
                                    Aspirin (see Arthritis and Pain).
                                    Atenolol Tablet.
                                    Carvedilol Tablet.
                                    ChlorthalidoneTablet.
                                    Clonidine Tablet.
                                    Diltiazem 24-Hour Capsule.
                                    Diltiazem HCL Tablet.
                                    Enalapril Maleate Tablet.
                                    Furosemide Tablet.
                                    Hydralazine HCL Tablet.
                                    Hydrochlorothiazide Tablet/Capsule.
                                    Hydrochlorothiazide/Lisinopril
                                     Tablet.
                                    Hydrochlorothiazide/Losartan Tablet.
                                    Hydrochlorothiazide/Triamterene
                                     Tablet/Capsule.
                                    Isosorbide Mononitrate SA Tablet.
                                    Lisinopril Tablet.
                                    Losartan Tablet.
                                    Metoprolol Succinate SA Tablet.
                                    Metoprolol Tartrate Tablet.
                                    Nifedipine SA Capsule.

[[Page 12790]]

 
                                    Nitroglycerin sublingual Tablet.
                                    Prazosin HCL Capsule.
                                    Propranolol HCL Tablet.
                                    Spironolactone Tablet.
Mental Health.....................  Amitriptyline HCL Tablet.
                                    Buspirone HCL Tablet.
                                    Bupropion HCL Tablet.
                                    Bupropion HCL SA (12HR-SR) Tablet.
                                    Bupropion HCL SA (24HR-XL) Tablet.
                                    Citalopram Hydrobromide Tablet.
                                    Duloxetine HCL EC Capsule.
                                    Escitalopram Oxalate Tablet.
                                    Fluoxetine Tablet/Capsule.
                                    Mirtazapine Tablet.
                                    Paroxetine Tablet.
                                    Sertraline HCL Tablet.
                                    Trazodone Tablet.
                                    Venlafaxine HCL Immediate (IR)
                                     Tablet.
                                    Venlafaxine HCL SA Capsule.
Respiratory Condition.............  Montelukast NA Tablet.
Seizures..........................  Gabapentin Capsule.
                                    Lamotrigine Tablet.
                                    Topiramate Tablet.
Thyroid Conditions................  Levothyroxine Sodium Tablet.
Urologic (Bladder and Prostate)     Alfuzosin HCL SA Tablet.
 Health.
                                    Doxazosin Mesylate Tablet.
                                    Finasteride Tablet.
                                    Oxybutynin Chloride IR Tablet.
                                    Oxybutynin Chloride SA Tablet.
                                    Sildenafil Tablet.
                                    Tamsulosin HCL Capsule.
                                    Terazosin HCL Capsule.
------------------------------------------------------------------------

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, approved this 
document on February 26, 2021, and authorized the undersigned to sign 
and submit the document to the Office of the Federal Register for 
publication electronically as an official document of the Department of 
Veterans Affairs.

Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.
[FR Doc. 2021-04458 Filed 3-3-21; 8:45 am]
BILLING CODE 8320-01-P


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