Is Viagra Covered By Insurance

Viagra’s Exclusion from Insurance Plans’ Coverage List

While it may depend on where patients live, most states in the United States exclude Viagra from their essential prescription drug list. The relatively high prices of Viagra and other ED drugs makes health insurers hesitant to cover these drugs. Each tablet of Viagra costs approximately, $60 and generic versions are often 50% cheaper. Given the nature of how the drug is used, a $30 generic tablet is still a burden to a majority of the affected individuals

In 2016, Caremark and Express Scripts dropped Viagra from their new list of covered drugs, leaving Cialis as the only option for ED patients who respond well to a PDE5 inhibitor. Fortunately, generic versions of the drug are now available, and more are scheduled to be released in the coming years. Most health insurance companies promote the use of generic drugs because they are cheaper, so they are more likely to cover generic sildenafil. Medicare, on the other hand, still covers Viagra, but patients need to be on a Medicare Advantage Plan or Medicare Part D stand-alone prescription drug plan.

The Advent of Viagra

During the Pre-Viagra era, ED was managed with modest success using vacuum constriction devices, hormonal therapy, penile prosthesis, injection therapy, and psychotherapy, to name a few options. Viagra has emerged as one of Pfizer’s most successful drugs. Its approval in March 27, 1998 brought billions of dollars to the company, but its hefty price tag also brought in the question of how cost-effective it is compared to other ED treatments.

The basics of Viagra

  • Viagra (sildenafil citrate) is a popular prescription medication for erectile dysfunction in men.
  • Viagra, the brand, remains expensive and is rarely covered by health insurance plans.
  • Impotence affects more than 30 million men in the US.
  • Owing to the high price point of the medication, the worldwide market is now brimming with counterfeit drugs and “cheap Viagra,” which is sold online.
  • Generic versions have been available since December 2017.

Impotence or erectile dysfunction (ED) is a common sexual disorder among men, particularly in individuals over 40. The condition becomes more common with age. While ED is caused by a number of physical and psychological factors, it is often a sign of an underlying medical condition, such as diabetes or high blood pressure. A person with ED is unable to achieve or maintain an erection long enough to have sexual intercourse. Please note that it’s normal not to always have an erection when aroused. However, if this is persistent and detrimental to quality of life, patients should seek medical attention.

Erectile dysfunction is classified based on its underlying causes. ED can be either organic or psychogenic. Organic impotence is the most common type of ED, and is caused by underlying medical conditions. On the other hand, psychogenic ED may be caused by anxiety, depression, guilt, stress, and other psychological and interpersonal factors.

Other Treatment Plans for Erectile Dysfunction

The discovery of Viagra in 1998 paved the way for other PDE5 inhibitors to be approved and marketed. Vardenafil (Levitra) and tadalafil (Cialis) are two Viagra alternatives that showed positive results for temporarily relieving the symptoms of ED. These two drugs work by increasing blood flow to the penis. A comparative review of clinical trials done for the three drugs showed that tadalafil was preferred by men with ED due to its long duration. Additionally, Vardenafil was found to be similarly effective to sildenafil, and was favored for not inducing altered color perception, which sometimes occurs with sildenafil use.

According to a report published in the Annals of Internal Medicine in 2000, Viagra appears to be more cost-effective than other accepted medical therapies. However, other factors may dictate whether insurance companies should cover the cost of the drug.

While an on-demand drug may be the most desired treatment option for ED patients, there are other promising treatment modalities for this ailment.