VIAGRA COVERAGE: ACOG Accuses Insurers Of Gender Bias
"Health insurers that cover the new impotence drug Viagra but don't pay for female contraception are guilty of 'gender bias,'" according to the American College of Obstetricians and Gynecologists (ACOG). In a statement being released today at its annual meeting, ACOG notes that many employer-sponsored plans are covering Viagra for men but not paying for women's birth control, which ACOG says places an unfair financial burden on women, USA Today reports. "Pregnancy is a medical condition, just like impotence. And the cost benefit of preventing pregnancy is much greater than treating impotence," said ACOG spokesperson Luella Klein of Emory University (Elias, 5/12).
Public And Insurers Divided
In a new CNN/USA Today/Gallup poll, 59% of people surveyed called Viagra a "good thing for society as a whole." At least half of the respondents say men who need Viagra should pay for it themselves; only 42% say health plans should cover the drug. Similarly, 55% say Medicare recipients should pay for Viagra themselves; 36% think Medicare should cover it. The survey of 1,005 adults was conducted May 8-10 and has a margin of error of +/-5% (release, 5/12). According to a Fox News poll conducted May 6-7, 40% of respondents believe plans that cover prescription drugs should cover at least some of the cost of Viagra, but 68% feel that plans that cover prescriptions should also cover "prescription birth control." The Fox News poll survey of 900 people had a margin of error of +/-3% (release, 5/8). USA Today reports that "[m]ost plans offered through insurance firms or HMOs have decided to cover Viagra or are leaning in that direction," authorizing 6 to 12 pills a month for impotent men. While about 90% of HMOs cover reversible female birth control, only half of fee-for-service do so. Larger, self-insured employer-sponsored plans are the most likely to cover the cost of contraceptives (5/12).
Paying For "Comfort Care"
Karen Ignagni, president of the American Association of Health Plans, describes the continued debate over insurer coverage of Viagra as "the beginning of a larger discussion of quality-of-life issues." Susan Pisano, vice president for communications at the AAHP, notes, "In the old days, we talked about things being therapeutic or cosmetic. Now there's something in between." Long regarded by managed care plans as belonging in the quality-of-life realm, infertility treatments may get a boost from the focus on Viagra, USA Today reports. Deborah Wachenheim, government affairs director for Resolve, a national infertility organization, said, "It is interesting that [Viagra] has gotten so much media coverage. There have been couples struggling with infertility for years, and it's pretty much ignored when people discuss whether there should be insurance coverage." Wachenheim notes that about 40% of HMOs offered by large companies and 60% of fee-for-service plans do not cover any type of infertility treatments (5/12).