Tough Choices: The Cost-Effectiveness of Sildenafil
Authors: Michael R. McGarvey
Journal: Annals of Internal Medicine (2000)

Editorials20 June 2000Tough Choices: The Cost-Effectiveness of SildenafilMichael R. McGarvey, MDMichael R. McGarvey, MDHorizon Blue Cross Blue Shield of New Jersey; Newark, NJ 07105-2200 (McGarvey)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-12-200006200-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When sildenafil (Viagra, Pfizer, Inc., New York, New York) was released to the U.S. commercial market in April 1998, it rocked the nation. Here was a simple-to-take oral treatment for erectile dysfunction; previous treatments had required penile injection, insertion of a urethral suppository, use of bulky mechanical suction devices, or surgical implants. Sildenafil sold for about $10 a pill.Reaction from the health insurance industry was swift—and confused. Most existing treatments for erectile dysfunction had been covered by insurers under the rubric of their policies on “medical necessity.” Such policies, which are used to determine insurance coverability, commonly invoke concepts ...References1. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54-61. CrossrefMedlineGoogle Scholar2. Smith KJ, Roberts MS. The cost-effectiveness of sildenafil. Ann Intern Med. 2000;132:933-7. LinkGoogle Scholar3. Mark DB, Hlatky MA, Califf RM, Naylor CD, Lee KL, Armstrong PW, et al . Cost-effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase in acute myocardial infarction. N Engl J Med. 1995;332:1418-24. CrossrefMedlineGoogle Scholar4. Stanford University Center for Health Policy. Decreasing variation in medical necessity decision making. Report to the California HealthCare Foundation. Grant #98-5021. August 1999. Google Scholar5. Custer WS, Ketsche P. Health insurance coverage and the uninsured: 1990-98. Center for Risk Mangement and Insurance Research, Georgia State Univ. Washington, DC: Health Insurance Association of America; 1999. Google Scholar6. Gabel JR. Job-based health insurance, 1977-1998: the accidental system under scrutiny. Health Aff Millwood. 1999;18:62-74. CrossrefMedlineGoogle Scholar7. Pfizer, Inc. Annual Report. 1999. Google Scholar8. In California, Kaiser loses Viagra ruling. New York Times. 1999; Jan 2:C6. Google Scholar Author, Article, and Disclosure InformationAuthors: Michael R. McGarvey, MDAffiliations: Horizon Blue Cross Blue Shield of New Jersey; Newark, NJ 07105-2200 (McGarvey)Corresponding Author: Michael R. McGarvey, MD, Horizon Blue Cross Blue Shield of New Jersey, 3 Penn Plaza East, PP-07B, Newark, NJ 07105-2200; e-mail, [email protected] PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Cost-Effectiveness of Sildenafil Kenneth J. Smith and Mark S. Roberts Metrics Cited byA Review of Economic Evaluations of Erectile Dysfunction TherapiesSexual Dysfunction in Men and WomenSexual Dysfunction in Men and WomenQuality-of-Life Utility Values for???Erectile Function and Sildenafil TreatmentHypogonadism, erectile dysfunction and infertility in menReview of patients with erectile dysfunction attending the Maudsley psychosexual clinic in 1999: The impact of sildenafilEconomic aspects of medical erectile dysfunction therapiesWe're Not Alone! 20 June 2000Volume 132, Issue 12Page: 994-995KeywordsErectile dysfunctionHealth insuranceMarkov modelsMedical conditionsMedical dialysisPopulation statisticsQuality adjusted life yearsSexual dysfunctionSuppositorySurgeons ePublished: 15 August 2000 Issue Published: 20 June 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...