Health

Large HMO's Nix Viagra

June 19, 1998 / 4:31 PM EDT / AP

Kaiser Permanente, the nation's largest health maintenance organization, won't cover patients' costs for the impotence drug Viagra because it would be too expensive.

Kaiser officials said today that limiting patients to 10 pills a month would cost Kaiser more than $100 million a year. That's more than 50 percent higher than what the HMO spent in 1997 for all anti-viral drugs, including protease inhibitors for treatment of HIV.

The company said doctors, ethicists and pharmacists were involved in the decision, which also considered such issues as the medical necessity of sex and the dangers of recreational use.

Some 2 million prescriptions have been written for Pfizer Inc.'s Viagra since it was approved by the Food and Drug Administration in April. The pills retail for up to $10 each.

Earlier this week, Aetna U.S. Healthcare said it wouldn't pay for Viagra and only about half of state-run Medicaid programs provide Viagra benefits.

Kaiser doctors can write prescriptions for Viagra, and the drug will be available in Kaiser pharmacies. But the standard $5 co-payment will not cover the cost. Kaiser officials also said they will continue to cover medical care associated with the treatment of sexual dysfunction, except for the cost of pharmaceuticals.

"As more and more similar drugs appear with increasing frequency, we are facing the very real possibility that health care in America will become so expensive that no one will be able to afford medical care," Crosson said.

Mariann Caprino, a spokeswoman for drug maker Pfizer, said the company was disappointed with the decision.