Avalere Health
An Inovalon Company
Insights

Feb 17, 2016

Veterans Administration and California Medicaid Drug Lists Cover Less than 60 Percent of Drugs Available to California Public Employees

The CalPERS Basic Plan Drug List, which is the formulary for all California public employees, includes 222 brand drugs and 287 generic drugs. In contrast, drug coverage in the Veterans Administration (VA) and Medi-Cal (California’s Medicaid program) is far more limited than the CalPERS drug list.

The VA National Formulary covers 54 percent of drugs on the CalPERS formulary, including 46 percent of brand drugs (102 of 222) and 61 percent of generic drugs (174 of 287). The Medi-Cal drug list covers 59 percent of drugs listed on the CalPERS formulary, including 43 percent of brand drugs (96 of 222) and 71 percent of generic drugs (203 of 287).

The full analysis is available here.

The Pharmaceutical Research and Manufacturers of America provided funding for this analysis. Avalere maintained full editorial control.

Methodology

Avalere analyzed the CalPERS Basic Drug List, the VA National Formulary, and the Medi-Cal Contract Drug List using the following, publicly available documents: CalPERS Basic Drug List (October 2015), VA National Formulary (October 2015), and Medi-Cal Contract Drug List (November 2015). Avalere used the CalPERS Basic Drug List as a basis for comparison, examining coverage across these three drug lists. For each brand medication, Avalere matched the brand drug to its chemical entity or generic equivalent. This allowed us to analyze the latest version of the VA National Formulary and Medi-Cal Contract Drug List, as both only identify drugs by their chemical entity or generic name. 

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