title: Health care cost implications of sildenafil citrate.
abstract: BACKGROUND
  As prescription drug expenditures increase, third-party payors are increasingly scrutinizing costs and reimbursement guidelines, such as for medications that treat chronic conditions that are not necessarily directly life threatening (i.e., obesity, nicotine addiction, and erectile dysfunction).
  
  
  OBJECTIVE
  To review the costs and consequences of pharmacy benefit reimbursement policies related to erectile dysfunction therapies, using sildenafil citrate as the case study.
  
  
  METHODS
  Data and references were found through searches of PubMed and Google.
  
  
  CONCLUSIONS
  To meet the varied health needs of a defined population under reasonable resource constraints requires analysis of cost and of the economic and non-economic consequences of a treatment. Based on analysis of sildenafil data, oral therapy of erectile dysfunction provides substantial cost savings when compared with other treatment options and contributes insignificant overall costs to health plans. Regardless, health plans impose controls to limit reimbursement. Because erectile dysfunction is often a precursor to other conditions, such limitations could compromise detection and management of underlying disease (e.g., depressive, cardiovascular, and urogenital). Reimbursement restrictions may also decrease membership satisfaction and re-enrollment rates.
authors.affiliation: Swansea Health Center, Swansea, MA, USA. martin_miner@brown.edu
authors.forename: Martin
authors.initials: M
authors.lastname: Miner
mesh_terms: D000328:Adult; D007172:Erectile Dysfunction / Q000188:drug therapy*; D017048:Health Care Costs / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D007356:Insurance, Pharmaceutical Services / Q000191:economics; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000191:economics / Q000627:therapeutic use; D010879:Piperazines / Q000191:economics* / Q000627:therapeutic use; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D014481:United States
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate