Cost-sharing for Prescriptions of Sildenafil and Finasteride

A Case Study in Veteran Patients

Published in: American Journal of Managed Care, v. 7, no. 4, Apr. 2001, p. 345-353

Posted on RAND.org on December 31, 2000

by Emily I. Yu, Peter Glassman, Steven M. Asch, Neil M. Paige, Leigh J. Passman, Paul G. Shekelle

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OBJECTIVE: To evaluate patients' willingness to share the costs of 2 medications (often described as lifestyle medications): sildenafil for erectile dysfunction and finasteride for hair loss, which are not routinely covered by the Department of Veterans Affairs (VA) healthcare system. STUDY DESIGN: Self-administered, anonymous survey. PATIENTS AND METHODS: Adult men (n = 339) were recruited from waiting rooms for primary care or erectile dysfunction clinic appointments at 2 Los Angeles VA facilities. RESULTS: Participants with self-reported need were analyzed separately for finasteride (primary care patients only) and sildenafil (both primary care and erectile dysfunction clinic patients). The mean age of the participants was 56 and 60 years for the finasteride and sildenafil groups, respectively. Mean annual household income for both groups was under $10,000, respondents reported a mean willingness to cost- share $4.20 for a 30-day prescription of daily finasteride (VA wholesale cost = $27) and $5.40 for 4 sildenafil pills (VA wholesale cost = $20). In the multivariate analysis, higher income (P= .002) and increasing self-reported need for medication (P= .04) were associated with increased willingness to cost-s are for finasteride after controlling for age, race/ethnicity, insured status, comorbid conditions, and type of clinic. In addition, younger age (P = .01) was associated with greater willingness to cost-share for sildenafile. CONCLUSIONS: In this low-income veteran population, patients with a self-reported need for sildenafil and finasteride would be willing to make a higher copayment than the current VA maximum copayment of $2.00 per 30-day prescription, if these medicines were made available.

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