Sexual performance drugs such as Viagra will be covered in Medicare’s new prescription drug program, a lifestyle rather than lifesaving benefit that conservatives and watchdog groups say the government shouldn’t provide.
Like those for maladies such as high blood pressure and heart disease, prescriptions for Viagra and similar drugs in its class will be tightly controlled. The new prescription coverage begins next Jan. 1 and is expected to cost more than $500 billion over the next decade.
“The law says if it’s an FDA-approved drug and it is medically necessary, it has to be covered,” said Gary Karr, spokesman for the Centers for Medicare and Medicaid Services, which administers the health insurance program for older Americans.
Pfizer’s Viagra, Bayer’s Levitra and Eli Lilly & Co.’s Cialis are used primarily to treat erectile dysfunction. Viagra might also prove useful in treating enlarged hearts that can result from high blood pressure.
Some conservatives and public watchdogs say Medicare coverage of sexual performance drugs could bankrupt the program.
“Asking Uncle Sam to pay for the romance of 76 million baby boomers will quicken the impending collapse of Medicare,” said Tom Schatz, president of a taxpayer watchdog group, Citizens Against Government Waste.
“These bureaucrats defend the additional drugs as ‘lifestyle-improving’ instead of ‘just lifesaving,’ but tax-funded Viagra will drain resources from medication for more severe conditions,” Schatz said.
Karr said no analysis has been done on the cost of covering prescriptions for sexual performance drugs.
Conservatives say the law puts Congress, and not doctors, in the position of deciding which drugs should be covered – precisely the kind of big-government role that majority Republicans and Bush campaigned against.
“You cannot have a universal entitlement like this without extreme micromanagement,” said Robert E. Moffit, a health care analyst at the Heritage Foundation.
“Members of Congress, frankly, are not competent to make these decisions,” Moffit added. “Micromanagement will institutionalize incompetence.”
On Capitol Hill Tuesday, talk turned to what types of drugs are covered by the new law. “We’re going to have to take another look at this whole drug benefit,” said Sen. Judd Gregg, R-N.H., the new chairman of the Senate Budget Committee.
Since it was approved by the FDA in 1998, about 16 million men have tried Viagra, according to Pfizer.
President Bush two years ago signed into law the voluntary drug benefit, which is expected to cover the drug expenses of 11 million low-income older and disabled people. The government contends the program also could cut drug costs in half for most seniors.
Medicare issued final rules last month for the prescription program, and low-income people will begin registering for it in June. Other recipients are to sign up in November.
The Los Angeles Times first reported Medicare’s coverage of sexual performance drugs.
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