The department has a strategy for containing the cost—not necessarily cutting the cost, but making sure that the costs of this program are reasonable and that they're able to deliver as much as they can within the money that they have. One of the strategies that they've put in place was a generic substitution policy that said, wherever possible and as long as it's acceptable to the prescribing physician, generics should be substituted for name brand drugs. That was one of the measures they put in place to manage the cost of the program.
What we've identified is that even though they've put that strategy in place, they haven't gone back to see how effective it is, whether it's working, or whether it's being done in all of the instances. They haven't done an evaluation on whether that particular strategy is working. Similarly, they have negotiated reduced dispensing fees with pharmacies, but again haven't gone back to analyze the success of that part of their program either.
There are ways that they can make sure they are containing the costs of the program while still making sure that veterans are getting access to the prescription drugs that they need.