Private insurance companies and cheap Viagra


One of the issues at stake with regard to cost had to do with the number of pills contained in a prescription. Unlike most pharmaceutical drugs that have to be taken in specific doses a certain number of times a days, Viagra is a useas – needed medication. So both Medicaid and private insurance companies that would cover cheap Viagra had to decide on what constitutes an appropriate supply. The military allows no more than six pills a month.J – ? In the New York Times, Robert Pear writes that Pfizer “suggests covering pills a month if states insist on a limit. But some states have set lower limits. Florida, for example, pays for pills a month. ” In Newsweek, Daniel McGinn reports that, according to Pfizer’s market research director, the subject of how many pills could send messages about what “a ‘normal’ sex life” is. As result, Pfizer made no recommendations initially, but felt compelled to do so once insurance became an issue. Cigna Healthcare decided to limit the pre – scription to six pills a month “based on estimates of an average couple’s needs.”

At the center of this debate is the question of the severity of erectile dys – function. Since ED is ” nonlethal and noncrippling,” states and insurance companies are loath to cover the costs of cheap viagrawhen other services would have to be limited, cut back, and/or eliminated altogether as a result of funding it. Meanwhile, Pfizer responded by saying that impotence “is a bona fide medical condition that has a tremendous impact on patients and their partners. ” Like New York and other states such as Wisconsin, insurance companies such as Kaiser, Prudential, and Humana expressed their reluctance to cover Viagra by pointing out how the cost for a drug that is medically unnecessary would infringe on treatment for more serious conditions. Other states and insurers required a documented diagnosis of organic impotence in order to qualify or “more stringent criteria for evaluating a patient’s medical need for the drug.” The military eventually “limited Viagra to men in whom erectile dysfunction has been diagnosed by a doc – tor.” Indeed, it was reported that even Secretary of Health and Human Services Donna Shalala considered Viagra’s potential for both clinical and financial abuse.

Another important consideration regarding Viagra’s impact on healthcare’s political economy was revealed when mandatory insurance coverage for Viagra catalyzed the discussion over birth control pills and their infrequent coverage. Carey Goldberg of the New York Times writes that, “For decades, women’s advocates had little success in pushing insurance coverage of contraceptives.” When Viagra was included in many insurance plans, ” these groups have been able to add to their arsenal of arguments the tough – to – beat issue of basic fairness. ” Opponents to contraception coverage ranged from the Catholic Church to antiabortion groups to business leaders to the U.S. Chamber of Commerce. While one – half to two – thirds of insurance companies do cover oral contraceptives, the significant differ – ence in overall out – of – pocket health costs between men and women – women spend percent more – can be traced to those insurance companies that don’t. In June , a federal judge ruled that not covering birth control “violated the Pregnancy Discrimination Act,” bringing the issue of coverage to a decisive moment.