What to do when CVS / Caremark denies Viagra coverage
Starting January 1, 2016, millions of patients taking prescription drug insurance through CVS / Caremark will no longer include many popular medications, including Viagra. The insurance provider said this week that it would drop 26 drugs from its list of covered drugs. Instead, they told patients could switch to cheaper alternatives.
“For all the drugs taken off the list, there are generic analogs with lower costs remaining available on the form,” CVS representative said in a statement to CBS News.
It leaves many wondering: “What is an effective alternative to the small blue pill?”
There is currently no generic version of Viagra in the US market. (No matter how many email solicitations or online ads you may have seen). The manufacturer Pfizer has an exclusive patent on the drug.
According to the USA Today, another drug for erectile dysfunction, Levitra from GlaxoSmithKline, is also being removed from the CVS / Caremark form.
However, Cialis from Eli Lilly & Co will be covered. Patients have to choose between lower or higher doses of Cialis: low-dose pills for daily use or high-dose medicines that are taken only when needed.
Although there are some differences between medications, WebMD says Viagra, Levitra, and Cialis all work in a very similar way by increasing blood flow to allow an erection. The medicines share a similar list of side effects such as headache, upset stomach or heartburn, hot flushes, nasal congestion, blurred vision, or hearing loss. Cialis can also cause back pain in some patients.
CVS pharmacies will continue to charge customers for Viagra if they are covered under different insurance plans or who pay out-of-pocket.
CVS says its pharmacy benefit management service has nearly 65 million members who can fill their prescriptions by mail or through almost 68,000 national retail pharmacies, including CVS stores and other pharmacies in their network.
Its competitor Express Scripts, the most significant pharmaceutical administrator in the United States, continues to cover Viagra and Cialis in 2016, but it does not include Levitra.
USA Today reports CVS / Caremark take off other medications off the coverage list such as Abilify (an antidepressant); Amitiza (for irritable bowel disease); Cymbalta (an antidepressant); Fosrenol (for kidney disease); And Diovan (for high blood pressure).
The company told CBS News that the changes in the list would be communicated to plan members, doctors, and pharmacies later.