Notice2026-07880

Tiered Pharmacy Copayments for Medications; Calendar Year 2026 Update

Primary source

Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.

Published
April 23, 2026

Issuing agencies

Veterans Affairs Department

Abstract

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

Full Text

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<title>Federal Register, Volume 91 Issue 78 (Thursday, April 23, 2026)</title>
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[Federal Register Volume 91, Number 78 (Thursday, April 23, 2026)]
[Notices]
[Pages 21874-21875]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-07880]


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DEPARTMENT OF VETERANS AFFAIRS

[Docket No. VA-2026-VACO-0001]


Tiered Pharmacy Copayments for Medications; Calendar Year 2026 
Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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

FOR FURTHER INFORMATION CONTACT: Tamara Wagner, Management Analyst, 
Office of Finance/Revenue Operations, Veterans Health Administration, 
(970) 242-0731, extension 2219.

SUPPLEMENTARY INFORMATION: Section 17.110 of title 38, Code of Federal 
Regulations (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 Sec.  
17.110. Not less than once per year, VA will identify a subset of 
multi-source medications as Tier 1 medications. Only medications that 
meet all 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 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 2026. The Tier 
1 medication list is posted on VA's website at the following link: 
<a href="http://www.va.gov/resources/va-tier-1-copay-medication-list">www.va.gov/resources/va-tier-1-copay-medication-list</a>.
    The following table is the Tier 1 Copay Medication List that is 
effective January 1, 2026, and will remain in effect until December 31, 
2026.

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             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.
Cholesterol.......................  Atorvastatin tablet, Ezetimibe
                                     tablet, Fenofibrate capsule or
                                     tablet, Pravastatin tablet,
                                     Rosuvastatin Calcium (CA) tablet,
                                     Simvastatin tablet.
Dementia..........................  Donepezil tablet.
Diabetes..........................  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 capsule,
                                     Psyllium (regular and sugar-free)
                                     bulk powder.
Glaucoma and Eye Care.............  Carboxymethylcellulose Sodium
                                     Ophthalmic Solution, Brimonidine
                                     0.2% ophthalmic solution,
                                     Diclofenac ophthalmic solution,
                                     Latanoprost (excludes preservative-
                                     free) 0.005% Ophthalmic solution,
                                     Polyethylene Glycol Ophthalmic
                                     solution.
Heart Health and Blood Pressure...  Amiodarone tablet, Amlodipine
                                     tablet, Aspirin (see Arthritis &
                                     Pain), Atenolol tablet, Carvedilol
                                     tablet, Chlorthalidone tablet,
                                     Clonidine tablet, Diltiazem 24-hour
                                     capsule, Diltiazem HCL tablet,
                                     Furosemide tablet, Hydralazine HCL
                                     tablet, Hydrochlorothiazide tablet/
                                     capsule, Hydrochlorothiazide/
                                     Lisinopril tablet,
                                     Hydrochlorothiazide/Triamterene tab/
                                     cap, Isosorbide Mononitrate SA
                                     tablet, Lisinopril tablet, Losartan
                                     tablet, Metoprolol Succinate SA
                                     tablet, Metoprolol Tartrate tablet,
                                     Nifedipine SA capsule,
                                     Nitroglycerin sublingual tablet,
                                     Prazosin HCL capsule,
                                     Spironolactone tablet, Valsartan
                                     tablet.
Hormones/Other....................  None.
Mental Health.....................  Amitriptyline HCL tablet, Buspirone
                                     HCL tablet, Bupropion HCL tablet,
                                     Bupropion HCL SA (12 hour-SR)
                                     tablet, Bupropion HCL SA (24 hour-
                                     XL) tablet, Citalopram Hydrobromide
                                     tablet, Duloxetine HCL EC capsule,
                                     Escitalopram Oxalate tablet,
                                     Fluoxetine tablet/capsule,
                                     Memantine tablet, Mirtazapine
                                     tablet, Paroxetine tablet,
                                     Quetiapine Immediate release (IR)
                                     Tablet, Sertraline HCL tablet,
                                     Trazodone tablet, Venlafaxine HCL
                                     IR tablet, Venlafaxine HCL SA
                                     capsule.
Neurologic Disorders..............  Ropinirole tablet.
Respiratory Condition.............  Montelukast Sodium tablet.
Seizures..........................  Gabapentin capsule, Lamotrigine
                                     tablet, Topiramate tablet.
Thyroid Conditions................  Levothyroxine Sodium tablet.

[[Page 21875]]

 
Urologic (Bladder and Prostate)     Doxazosin Mesylate tablet,
 Health.                             Finasteride tablet, Oxybutynin
                                     Chloride SA tablet, Sildenafil
                                     tablet, Tadalafil tablet,
                                     Tamsulosin HCL capsule, Terazosin
                                     HCL capsule.
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(Authority: 38 U.S.C. 501; 38 CFR 17.110(b)(3))

    Signing Authority: Douglas A. Collins, Secretary of Veterans 
Affairs, approved this document on April 16, 2026, 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.

Gabriela DeCuir,
Alternate Federal Register Liaison Officer, Department of Veterans 
Affairs.
[FR Doc. 2026-07880 Filed 4-22-26; 8:45 am]
BILLING CODE 8320-01-P


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Indexed from Federal Register on April 23, 2026.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.