Cost-sharing for prescriptions of sildenafil and finasteride: A case studyin veteran patients

Objective: To evaluate patients' willingness to share the costs of 2 medica tions (often described as "lifestyle medicdtions"): sildenafil for erectile dysfunction and finasteride Tor hair loss, which are not routinely covered by the Department of Veterans Affairs (VA) healthcare system. Study Design: Self-administered, anonymous survey. Patients and Methods: Adult men (n = 339) were recruited from waiting rooms for primary care or erectile dysfunction clinic appointments at 2 Los Angeles VA facili ties. Results: Participants with self-reported need were analyzed separately for finasteride (primary care patients only) and sildenafil (both primary care and erectile dysfunction clinic patients). The mean age of the participants was 56 and 60 years for the finasteride and sildenafil groups, respectivel y. Mean annual household income for both groups was under $10,000. Responde nts reported a mean willingness to cost share $4.20 for a 30-day prescripti on oi daily finasteride (VA wholesale cost = $27) and $5.40 for 4 sildenafi l pills (VA wholesale cost = $20). In the multivariate analysis, higher inc ome (P = .002) and increasing self-reported need for medication(P = .04) we re associated with increased willingness to cost-share for finasteride afte r controlling for age, race/ethnicity, insured status, comorbid conditions, and type oi clinic. In addition, younger age (P = .01) was associated with greater willingness to cost-share for sildenafile. Conclusions: In this low-income veteran population, patients with a sell-re ported need for sildenafil and finasteride would be willing to make a highe r copayment than the current VA maximum copayment of $2.00 per 30-day presc ription, ii these medicines were made available.