title: Cost-sharing for prescriptions of sildenafil and finasteride: a case study in veteran patients.
abstract: 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.
  
  
  METHODS
  Self-administered, anonymous survey.
  
  
  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-share 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 sildenafil.
  
  
  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.
authors: Center for the Study of Healthcare Provider Behavior, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. emily.yu@med.va.gov
authors: E I
authors: EI
authors: Yu
authors: P A
authors: PA
authors: Glassman
authors: S M
authors: SM
authors: Asch
authors: N M
authors: NM
authors: Paige
authors: L J
authors: LJ
authors: Passman
authors: P G
authors: PG
authors: Shekelle
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000188:drug therapy / Q000191:economics*; D001294:Attitude to Health; D017047:Cost Sharing / Q000706:statistics & numerical data*; D016527:Drug Costs; D004791:Enzyme Inhibitors / Q000191:economics* / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000191:economics*; D018120:Finasteride / Q000191:economics* / Q000627:therapeutic use; D019538:Health Care Surveys; D006787:Hospitals, Veterans / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000191:economics* / Q000627:therapeutic use; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D004791:Enzyme Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D018120:Finasteride; D000068677:Sildenafil Citrate