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Posted 9/12/2014 4:17 PM (GMT 0)
I am a 66 year old male who suffers from erectile dysfunction secondary to prostate cancer. I had the prostatectomy on 5 December, 2013 to treat my cancer, which was recommended from my physician. Prior to that I had normal penis erectile functions. Since the procedure, I suffer from decreased blood flow to my penis which has cause my erectile dysfunction. My urologist, provided me with Cialis samples, which had started to help in starting the return of blood flow my penis.

My Insurance has refused to pay for the Cialis. How do I get the Insurance to understand that it is part of my post prostatectomy treatment? shakehead
Posted 9/12/2014 4:26 PM (GMT 0)
Hi Richard,

Click on my name and send me an email.

NolaVette
Posted 9/12/2014 6:33 PM (GMT 0)
Richard,
My Uro wrote a letter to my insurance company telling them the Cialis was needed as part of my treatment post surgery. Insurance company approved use for one year. Good luck!
Posted 9/12/2014 6:55 PM (GMT 0)
I've pleaded with my insurance company and even the pharmacy to help me out in this same situation. They have been adamant that there is only one exception to their rules against PDE5 inhibitors being covered. A letter from my doctor was not of interest to them. The exception is for BPH, when at least two other meds have failed. Because I don't have a prostate any more, it's hard to argue that I have BPH.

I am in the process of getting a new written script from my doctor. I will then fax it to a Canadian pharmacy, and my order will be transferred to India. I will then get a full year's supply of generic tadafalil for about $200 plus shipping. This is about what I am paying per month out of pocket in the US.

Generic Viagra will be allowed in the US in 2017, under an agreement that allows the patent to otherwise stay in place until 2020.

The best hope for lower prices in the US will be when Viagra is finally off patent, which may force the manufacturers of other PDE5 inhibitors to lower their prices somewhat to compete with the generic Viagra.

In the interim, I'm going to use the Canadian pharmacy (Cialis is still under patent there) to get the generic drug from India. It really sucks that something called "insurance" is really nothing of the kind - just a cold-hearted profit center.

edit: Replaced "Cialis" with "Viagra" in line about generic availability.
Posted 9/12/2014 7:23 PM (GMT 0)
Interestingly, Viagra is still protected by a patent but the drug it contains -- sildenafil -- is not. Sildenafil is used to treat erectile dysfunction and for that use is protected by a patent for several more years. The patent holder sells it as "Viagra". But sildenafil is also used in a smaller dose to treat pulmonary arterial hypertension and the brand-name for sildenafil for that purpose is "Revatio". The patent for Revatio has expired and there are several legal generics available in the US for it -- and they are all sildenafil (same exact drug as in Viagra.)

A fairly typical dose of Viagra is 100mg (although some guys do fine with less and a few use more). To get the same amount of sildenafil from generic Revatio you will need five 20mg pills. But since Viagra costs something like twenty times as much per pill as generic Revatio does, even taking them five at a time you can reduce your cash cost by a factor of three or four by getting your doctor to write a scrip for off-label generic Revatio for your ED.

Of course, since it is off-label your insurance still won't want to pay -- unless they are on the hook to pay for your Viagra in which case they will be all about getting you to switch -- but you can save a few bucks that way. (You may have to shop around a bit but you can usually find generic revatio at local pharmacies for about a buck a pill).
Posted 9/12/2014 8:32 PM (GMT 0)
My husband asked the PA of his surgeon for a prescription for Revatio and she refused to write it because it is for off-label use. She claimed that the PA before her lost her job because she wrote a prescription for Revatio and it was investigated.

If you want to buy from a US pharmacy I found that Costco had the best prices. If you go to the Cialis website you can get a coupon for a month of free pills. My husband got 30 5mg. pills for free. Viagra and Levitra also have free and discounted coupons on their websites.

My husband's insurance will not pay for PDE5i pills.
Posted 9/12/2014 9:26 PM (GMT 0)
My surgeon not only writes off-label prescriptions for the generic sildenafil, his office will also sell it to their patients at about a buck a pill.
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