Document
This Department of Veterans Affairs (VA) Notice updates the information on Tier 1 Medications.
Department of Veterans Affairs.
Notice.
This Department of Veterans Affairs (VA) Notice updates the information on Tier 1 Medications.
Tamara Wagner, Management Analyst, Office of Finance/Revenue Operations, Veterans Health Administration, (970) 242-0731, extension 2219.
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 § 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 § 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: www.va.gov/resources/va-tier-1-copay-medication-list.
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.
| 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 Inhibitors | Clopidogrel Bisulfate tablet. |
| 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. |
| ( printed page 21875) | |
| Urologic (Bladder and Prostate) Health | Doxazosin Mesylate tablet, Finasteride tablet, Oxybutynin Chloride SA tablet, Sildenafil tablet, Tadalafil tablet, Tamsulosin HCL capsule, Terazosin HCL capsule. |
(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
Legal Citation
Use this for formal legal and research references to the published document.
91 FR 21874
Web Citation
Use this when citing the archival web version of the document.
“Tiered Pharmacy Copayments for Medications; Calendar Year 2026 Update,” thefederalregister.org (April 23, 2026), https://thefederalregister.org/documents/2026-07880/tiered-pharmacy-copayments-for-medications-calendar-year-2026-update.