If you’re reading this, I assume you’re already aware that Viagra, the popular drug that treats erectile dysfunction, is on its way to becoming the most prescribed drug in the world. What you might not know is that behind this success is a long history of controversy and shifting regulations that has led to a complete overhaul of how health insurers and third-party payers (HMOs, PPOs, and HCCPs) cover the cost of erectile dysfunction medicine.
The Facts About Viagra
First off, let’s get some basics down. There’s no question that Viagra is effective. According to research, it helps improve erectile dysfunction in 62% of men and controls hypertension in 96% of patients. As noted by the U.S. Food and Drug Administration (FDA), there’s also no question that Viagra is safe when used as directed. The drug’s components are bio-equivalent to those approved by the FDA, and there are no known serious side effects. In fact, research has shown that the drug actually improves cardiovascular health.
Viagra has been around for more than a decade, and it’s one of the few life-improving medicines that most people have heard of. It’s also one of the few drugs that health insurers have covered medically for years. Until recently.
What Is The Reimbursement Regime For Viagra?
As noted above, Viagra has been around for a while, and most people have already heard of the drug. Most people also know that Viagra is one of the few drugs that continue to see increasing insurance coverage. For example, Blue Cross Blue Shield of North Carolina (BCBSNC) began coverage for Viagra in 2008, but it wasn’t until 2011 that Viagra coverage hit its highest level ever. In 2012, Viagra coverage increased by 22%, and in 2013 it rose by 16% compared to 2012.
What many people might not realize is that the cost of Viagra continues to rise. The average cost for a 30-day supply of the drug was $375 in 2001, increasing to $482 in 2010 and $540 in 2013. It’s important to note here that while the average cost of a 30-day supply has increased, the cost per pill has decreased, falling from $9.60 in 2010 to $8.40 in 2013. For comparison, a 30-day supply of Lipitor, a cholesterol-lowering drug, increased from $359.10 to $412.80 during the same timeframe. This is likely due to increased generic competition, as well as the fact that more people are becoming eligible for prescription drug coverage.
Coverage for Viagra was limited in the past, with most large employers requiring their employees to pay out of pocket for the drug. That has changed, as most large companies now provide drug coverage to their employees. In addition, many Medicaid and Medicare recipients are also covered by the drug. These groups of people usually see their doctors more often than the average person, and that leads to a higher utilization rate of Viagra. Most health insurance providers, including Medicare, cover Viagra 100% – including copays and deductibles.
Why Have Insurance Carriers And Third-Party Payors (TPPs) Slashed Coverage For Viagra?
While the reimbursement rate for Viagra has increased over the years, it remains the lowest of any drug commonly used to treat erectile dysfunction. This is largely because of the complexity of the drug and its complications. As a result, insurance carriers and TPPPs were hesitant to cover the cost of Viagra therapy, especially since the drug isn’t considered an essential medication. As noted by Karen Moline, PhD, vice president of research and economics at the Kaiser Family Foundation, “While most people have heard of Viagra, it is not yet widely known that it is not considered an essential medication. For that reason, most plans do not generally cover the costs of treatment with this drug. That is most likely going to change now that its reputation as a safe and effective treatment for erectile dysfunction has been established.”
Kaiser also cites another reason why insurance coverage for Viagra has been limited in the past. Specifically, she notes that in 2011 the drug manufacturer Pfizer Inc. (NYSE:PFE) agreed to pay $3.5 billion to settle lawsuits related to its illegal marketing of Bextra, a drug that the company also markets under the name Celebrex. Bextra was approved by the FDA in 1994 and was marketed for rheumatoid arthritis and osteoarthritis. However, according to the lawsuits, Pfizer illegally promoted the use of Bextra for menstrual symptoms, fever, and arthritis, so it could sell more of the drug. While Pfizer eventually stopped promoting Bextra for those uses, the litigation established that the drug was being prescribed for those conditions anyway, leading to higher-than-average utilization rates of Bextra. That, in turn, led to a greater insurance payout for the drug due to the provisions of the Omnibus Budget Reconciliation Act of 1993 (OBRA ’93), which requires HMOs to cover preventable hospital and physician visits.
Reimbursement Changes For Viagra
As noted above, the cost of a 30-day supply of Viagra has increased significantly over the years. While the average cost per pill has declined due to decreased retail prices, that hasn’t been able to keep up with the increasing cost of the drug. As a result, in 2013 reimbursement rates decreased by 16% for Generic Cialis and 22% for Viagra. In 2014, those numbers are predicting a decline of more than 30%. Those are substantial decreases, but it’s important to keep in mind that Viagra is still considered a low-cost drug compared to many others.
One of the reasons why Viagra’s cost has increased in recent years is because of the growing number of people getting help for erectile dysfunction. According to the American Psychiatric Association, about 29.2 million American adults experience some type of erectile dysfunction. That’s roughly one in four men. For women, the figure is about 12.2 million, or one in eight women. This means that more and more people are seeking help and making prescriptions for erectile dysfunction medicine, which often leads to higher utilization and, consequently, increased costs. To make matters worse, the cost of treating erectile dysfunction is becoming more and more unpredictable due to the constantly shifting Medicare reimbursement rates and the limited number of insurers that cover the cost of the drug. As a result, many people are wondering how much longer they can afford to pay for treatment of this common medical issue.
How Long Does It Take For Viagra To Work?
There’s no question that Viagra works quickly, with the majority of men reporting improvements within 30 minutes of taking the drug. However, it doesn’t always happen that quickly. In fact, one study noted that it takes up to an hour for the drug to start working. That’s a long time for a man to keep a boner going when he knows he has to get back to work in a bit.
Are There Any Effective Treatments For Viagra?
If you’re reading this and you’re wondering whether or not there are any alternatives to Viagra for treating erectile dysfunction, you’re in luck. There are several natural supplements and behavioral therapies that are effective in helping men with erectile dysfunction. According to the American Psychiatric Association, these include the following: