Non-formulary drugs at the VA

morhets

PEB Forum Regular Member
Is anyone experiencing problems with getting the medication they need from the VA system? Three of the medications that I was prescribed when I was med boarded out are not on formulary. One of my drugs, Lyrica, I was on for over two years in the Army. I was denied it by neurology and internal medicine at the VA. They said they could write me a prescription and I could buy it myself. This drug (Lyrica) I take 4 pills a day which is about 2.20 per pill. I couldn't afford to pay almost $300 per month for this. The other drug, Topomax was denied as well and it would have cost me about $275 per month. Fortunately, my wife didn't accept their "NOs". She complained to the doctor and the pharmacy. The doctor was supportive but couldn't do much. She complained to the Patient Advocate and still got a no. She then went to the administrative floor and sat and waited to speak to the Chief of Staff for the medical division. She had found the criteria for non-formulary request for Lyrica on the VA website. I met all of the criteria. Within one day of meeting with the Chief of Staff my Lyrica was approved with a 90 supply and 3 refills.

Never accept no for an answer, our health is more important. If you have questions, comments or concerns about how to obtain the non-forumulary medications let me know. I am interested in hearing from people who have been denied and for what medications. I am taking this up the chain at the VA.

Bill
[email protected]
 

Jason Perry

Benevolent Leader
Site Founder
Staff Member
PEB Forum Veteran
Registered Member
Bill,

Kudos for fighting for what you are entitled to and for sharing this. I am sure there are others in the same boat you were.
 

cvma544

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
For what it is worth, I use Imitrex, not on VA formulary, (Zomig is formulary) my neurologist (Contract at VA clininc not full time) said I needed it as Zomig wasn't working, they approved it.

Guess at some VA's you gotta fight.........silly isn't it.




Stu
 
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