Feldman WB, et al. - Compared with Medicare Part D, the US Department of Veterans Affairs (VA) receives a minimum discount for prescription drug purchases. The VA also relies on price negotiation and a national formulary to restrict outpatient drug spending. In a 2019 study, investigators found that Medicare could have saved $14.4 billion in 2016 from an estimated $32.5 billion in spending if it used VA-negotiated prices for the 50 most expensive Part D oral drugs. Of the 50 costliest drugs, inhaled and injectable products 16 covered under Medicare Part D in 2016. The current study researchers found that Medicare could have saved $4.2 billion of an estimated $7.3 billion in spending on inhalers in 2017 by using VA-negotiated prices and the VA formulary.