Viagra


Viagra Touches Off Safety and Health Care Coverage Controversy

Viagra® (sildenafil citrate), the prescription drug for treating male impotence, has been making news since it was put on the market last spring. This controversial drug’s most recent foray into the news suggests interesting human resources implications.

In November, The Wall Street Journal reported the Federal Aviation Administration’s most recent medical newsletter to FAA-certified doctors is advising pilots to wait at least six hours after using the drug before flying. Viagra, which is made by Pfizer Inc. based in New York City, can cause temporary problems with some users’ color perception. The ear is that pilots could confuse blue and green, which are used in cockpit display and landing guides at airports. The article also states daily use of Viagra is “incompatible” with safe flight.

However, since prescription drugs such as Viagra are legal, their use on the job isn’t clear­ly prohibited. “Most company policies don’t deal with the effects of prescription medi­cation,” says Matthew Fagnani, president of WorkSafe Inc. of Anchorage, Alaska, a firm that provides drug-testing programs to employ­ers. “The reason is you have rules that come into effect, such as the Americans With Dis­abilities Act, confidentiality between patients and doctors, and who in the company has a need to know that information.

“We’ve suggested to companies in which safety-sensitive issues are a concern that if employees are given a prescription medication by their physician that alters or limits their ability to perform their safety-sensitive duties, they should notify management or notify their supervisor,” adds Fagnani, who’s also president-elect of the Substance Abuse Program Administrators Association, based in Glenview, Illinois. “This puts some of the responsibility onto the employee.”

Viagra has also touched off a controversy about companies that cover the cost of male impotence drugs like Viagra, but don’t cover contraception costs. A 1994 report by The Alan Guttmacher Institute in New York City, which studies reproductive health, found that 97 percent of large group health insurance plans pay for prescription drugs, but only a third covered birth control pills. Women pay, on average, 68 percent more out-of-pocket health care expenses than men.

Health insurance coverage for contraceptive services lags far behind coverage for obstetric care, abortion and sterilization, which are included in most health care plans.

A consulting group, Westport, Connecticut-based IMS Health Inc., which tracks drug statistics, says almost half the 300,000 men taking Viagra weekly are reimbursed, at least in part, by their health insurers. The pills cost about $10 each. Most insurers are approving 10 to 15 pills a month, although some limit coverage to four a month.

Family-planning and women’s groups have been pressing lawmakers in Congress to force employers to cover the costs of contraception as a health benefit. Last April, Maryland was the first state to mandate coverage of prescription contraceptives in workers’ health insurance plans. The legislation took effect in October. At least a dozen other state legislatures are considering similar measures.

Other bills, including one named “The Pill Bill,” proposed by Senator Olympia Snowe (R-Maine) and Representative Jim Greenwood (R-Pennsylvania), have been introduced in both the Senate and House that would cover contraceptive prescription costs for many private-sector workers. The Senate and House have approved provisions, attached to appropriations bills, that would require the federal government to offer all commonly prescribed forms of contraception, including birth control pills, intrauterine devices and diaphragms, to its 2.4 million employees who have health insurance.

Some HMOs that cover private-sector workers are refusing to cover the little blue impotence pill, too. For instance, Kaiser Permanente, Aetna/U.S. Healthcare Inc., Fallon Healthcare Systems arid HealthPartners are refusing to cover Viagra prescriptions for now.

Impact: Human resources professionals should review policies regarding prescrip­tion drug usage on the job to ensure safety for workers and the people whose work they affect. HR plan administrators also should review the coverage of drugs under their health insurance plans to maintain health plan fairness and equality for all workers.

Viagra: most recailed DTC brand in '06

news stories about Cox-2 drugs and ads for Viagra were the most recalled by consumers, according to a Verispan survey.

Pfizer's little blue pill was the most recalled among advertised brands in US and Europe (particularly France) in 2006, accounting for 14% of all product mentions in Verispan's Pharmaceutical Company Image 2006 survey. Lilly's Cialis was next, with 8% of mentions, followed by Pfizer's Lipitor and AstraZeneca's Nexium, both with 6%. Lunesta placed fifth, with 5.4% of mentions, and Ambien placed seventh, with 3.2% of mentions.

Viagra seems to have benefited from its sexy indication and powerful brand recognition. Nexium ranked first in DTC spending for 2005, according to Verispan's DTC Audit, while Viagra ranked 17th.

When it came to news stories recalled by respondents, Merck's Vioxx topped the list at 16% of product mentions, followed by Pfizer's Celebrex, at 8%. Insomnia leaders Lunesta and Ambien were new entrants at 3.4% and 3.1%, respectively. A quarter of respondents said drug ads prompted them to discuss treatment options with a physician.

The study, executed every two years, was drawn from more than 2,200 respondents.