Most Medicare prescription-drug plans will stop covering Viagra and other erectile-dysfunction medications next year.
Many beneficiaries are learning of the change this week as they receive materials explaining next year's benefits.
Medicare is a federal health plan available to all Americans age 65 and older, as well as some younger people with disabilities. Enrollment for 2007 will begin Nov. 15.
Medicare's decision follows a similar policy change last year by Medicaid, the nation's health plan for the poor.
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Several insurers who run the drug plans said they supported the change. Dr. Charles Willey, chief executive of Essence Inc. of Creve Coeur, one of the insurers, said paying for the medications was not the best use of the nation's limited health care dollars.
"We have to decide what our priorities are," said Willey, whose Medicare Advantage plan offers drug, physician and hospital coverage under one benefit.
Most health plans offered by Anthem Blue Cross Blue Shield of Missouri, including plans offered to private employers, don't cover erectile-dysfunction drugs, said Deb Wiethop, a spokeswoman. UnitedHealthcare Corp. offers one Medicare plan that covers the drugs. Its other Medicare plans exclude them.
Medicare will continue to cover the drugs, however, if they're used to treat other conditions, such as pulmonary hypertension, for which they've been approved.
There was a heated debate in Washington two years ago as legislators drafting the Medicare prescription-drug bill grappled with whether to include the drugs in the original benefit.
Drug makers and the American Urological Association successfully fought legislators who questioned whether the drugs were more of a lifestyle choice than a necessary medication.
At the time, the Congressional Budget Office estimated coverage of the drugs would cost Medicare almost $2 billion over 10 years. Negotiating discounts and managing usage probably would have helped reduce that figure.
The Department of Veterans Affairs, which covers erectile-dysfunction medications, has negotiated discounts of up to 50 percent for the pills.
For people without insurance, Viagra, Cialis and Levitra typically cost $9 to $11 a pill. Erectile dysfunction is most prevalent among those ages 65 and above; the Congressional Kidney Caucus estimates it affects 30 million men nationwide.
Medicare beneficiaries looking for more information can use a new feature at the agency's Web site,
www.medicare.gov. The prescription-drug plan finder, launched Friday, includes information on premiums, covered medications and costs.
Labels: No Prescription, Online Pharmacy, Prescription Drugs
# posted by Network @ 7:17 PM
