VA Health Care:

Modernizing VA's Mail-Service Pharmacies Should Save Millions of Dollars

HRD-92-30: Published: Jan 22, 1992. Publicly Released: Jan 22, 1992.

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Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) mail-service pharmacies, focusing on: (1) whether VA pharmacies efficiently and economically fill veterans' prescriptions; and (2) ways that VA could improve its mail pharmaceutical services.

GAO found that: (1) although VA mail-service pharmacies are capable of filling prescriptions in 90-day quantities, most routinely dispense drugs in 30-day quantities; (2) dispensing drugs in 30-day quantities causes VA to incur unnecessary mail-handling costs, since mailing drugs generally costs more than the drugs themselves; (3) VA could save as much as $34 million annually by reducing the number of mail-service pharmacies and modernizing them to increase productivity; (4) in a February 1989 circular, VA informed its pharmacies that they could submit consolidation and automation plans to regional directors, but only a few of the 226 pharmacies developed plans to change their operating practices; and (5) in 1991, VA headquarters pharmacy officials developed a pilot test study to test equipment and assess the operational requirements of consolidated, automated mail service pharmacies.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: VA reports that 164 of 167 facilities have either implemented multi-month dispensing or have approved it for implementation. As a result, VA dispensed 15.7 million fewer prescriptions in fiscal year 1995 and 9.4 million in 1994. VA expects to dispense about 20 million fewer prescriptions in fiscal year 1996.

    Recommendation: The Secretary of Veterans Affairs should direct the Chief Medical Director to require pharmacies to maximize the use of 90-day supplies when dispensing maintenance drugs, which are prescribed at a stabilized dose.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: VHA has been directed to determine pharmacy dispensing capacity assuming maximum use of 90-day quantities. VHA plans to do this as part of an FY 1994 evaluation of the expansion of the automated Consolidated Mail Outpatient Pharmacies.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to ensure that VA plans for consolidating and automating mail-service pharmacies determine the optimal work load for the pharmacies by using work-load data that assume maximum use of 90-day supplies.

    Agency Affected: Department of Veterans Affairs

  3. Status: Closed - Implemented

    Comments: VA has four consolidated mail-service pharmacies in operation, another one about to begin operation, and 2 more planned. When completed, VA will have a total of 7 facilities.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to ensure that VA plans for consolidating and automating mail-service pharmacies include steps for selecting the most cost-efficient locations for the facilities, considering such factors as available transportation and personnel.

    Agency Affected: Department of Veterans Affairs

  4. Status: Closed - Implemented

    Comments: VA plans for a CMOP program include equipment compatibility from site to site and use of automated data processing equipment nationwide. Software has been developed, tested, and distributed to the medical centers. However, not all medical centers have the capability to use the software. VA expects that all medical centers will be online by January 1998.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to ensure that VA plans for consolidating and automating mail-service pharmacies ensure compatibility of prescription handling and automatic data processing equipment throughout VA facilities to maximize efficiency.

    Agency Affected: Department of Veterans Affairs

 

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