The US Department of Veterans Affairs (VA), unlike Medicare Part D, receives a minimum discount for prescription drug purchases and additionally relies on price negotiation and a national formulary to limit outpatient drug spending. A 2019 study found that Medicare could have saved $14.4 billion in 2016 from an estimated $32.5 billion in spending if it used VA-negotiated prices for the 50 costliest Part D oral drugs.¹ Inhaled and injectable products represented 16 of the 50 costliest drugs covered under Medicare Part D in 2016.² Recently, our research group reported that Medicare could have saved $4.2 billion of an estimated $7.3 billion in spending on inhalers in 2017 by using VA-negotiated prices and the VA formulary.³

与 Medicare D 部分不同，美国退伍军人事务部 (VA) 在购买处方药时获得最低折扣，此外还依靠价格谈判和国家处方集来限制门诊药物支出。2019 年的一项研究发现，如果使用 VA 协商的 50 种最昂贵的 D 部分口服药物的价格，Medicare 可以在 2016 年从估计的 325 亿美元支出中节省 144 亿美元。¹吸入和注射产品代表了 2016 年医疗保险 D 部分涵盖的 50 种最昂贵药物中的 16 种^。2最近，我们的研究小组报告称，医疗保险本可以在 2017 年通过使用 VA 协商的吸入器支出节省 42 亿美元。价格和 VA 处方集。³