KAISER PERMANENTE: State Investigates Viagra Exclusion
State Department of Corporations officials launched an official investigation Thursday into the legality of Kaiser Permanente's decision last month not to cover the impotence drug Viagra. The Los Angeles Times reports that officials from the agency "ha[ve] been reviewing Kaiser's position regarding Viagra for over a month" to determine if it violates a California law that requires HMOs to cover medially necessary treatments. In addition, four state legislators wrote to Corporations Commissioner Dale Bonner and said the department "'can lift, and should lift' Kaiser's license to operate in California if" the HMO violated regulations. At a news conference at the Capitol Thursday, they called on the agency to review Kaiser Foundation Health Plan's exclusion of coverage. Corporations department spokesperson Julie Stewart said the agency is reviewing Kaiser's employer contracts to determine whether agreements excluding Viagra are legal.
It's Just Not So
Kaiser officials responded Thursday by saying their denial of Viagra coverage is "within the law." Although the "HMO is in the process of changing its rules for providing Viagra," it is not expected to significantly ease access (Vanzi, 7/3). Officials also stressed that Kaiser "would continue to cover other treatments for impotence -- such as penile implants and injections. Kaiser Permanente Foundation Executive Director Francis Crosson added that employers would be allowed to purchase supplemental coverage for Viagra, saying that as a fully covered benefit, the pill is too costly (Bernstein, Sacramento Bee, 7/3). The Times notes that Kaiser said covering Viagra would cost an estimated $100 million annually.
Act Up
Health activists have expressed concern that "men with conditions such as prostate cancer have shied away from needed treatment rather than submit to procedures that may leave them impotent." They said Viagra may be especially important for this population. Others said "far from being merely a drug to enhance sexual stamina," Viagra "is an essential and preferred alternative to more complicated and expensive procedures that allow impotent men ... to achieve erections" (7/3).