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Gellad WF, Good CB, Lowe JC, Donohue JM. Variation in prescription use and spending for lipid-lowering and diabetes medications in the Veterans Affairs Healthcare System. The American journal of managed care. 2010 Oct 1; 16(10):741-50.
Despite the existence of a closely managed formulary, significant variation in prescription spending and use of brand-name drugs exists in the VA. Although we could not explicitly risk-adjust, there appears to be no relationship between prescription spending and quality of care.