Ann Intern Med. Smith A. An Inquiry into the Nature and Causes of the Wealth of Nations. Preferences of husbands and wives for prostate cancer screening. Arch Fam Med. Med Decis Making.
Medical necessity is a complex issue.
The authors framed their study as a clarification of the mechanics of insurer decision making yet provide no evidence that insurers do, in fact, make coverage decisions on the basis of cost-effectiveness thresholds. Thus, the results of this analysis provide little insight into the extent that coverage decisions about sildenafil have been based on cost-effectiveness. Even if insurers did use a cost-effectiveness criterion, the authors' analysis probably overstated the disutility of erectile dysfunction. Sildenafil is not a cure and probably does not restore all lost utility. The cost-effectiveness of sildenafil.