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Biotech / Medical : PFE (Pfizer) How high will it go? -- Ignore unavailable to you. Want to Upgrade?

To: Anthony Wong who wrote (1797)	4/29/1998 5:43:00 PM
From: Early Out	Read Replies (1) \| Respond to of 9523

As was previously reported by the market-research firm IMS Health, new Viagra prescriptions totalled 113,134 in the week ended April 17, accounting for 94.4% of all new prescriptions for erectile-dysfunction therapies Doesn't IMS just report the number of new scripts reimbursed by insurance? In other words, it would be completely possible for their numbers to go down, while the actual number of total scripts of Viagra went up, due to the cash sales. Can someone clarify this for me? Thanks -jsc

To: Anthony Wong who wrote (1797)	4/29/1998 6:00:00 PM
From: Anthony Wong	Respond to of 9523

AP News - APRIL 29, 16:59 EDT Insurers Ask Questions About Viagra By JOHN HENDREN AP Business Writer NEW YORK (AP) -- As health insurers scramble to decide whether to cover a popular new pill for impotence, many have set up temporary rules to make sure the drug goes to impotent men and not would-be Casanovas looking to spice up their sex lives. For now, Cigna HealthCare will let some patients use the Pfizer drug, Viagra, but only if they are already using a rival treatment, such as injections or penile implants. HMO giant Kaiser Permanente is considering covering only half the drug's cost. California's WellPoint Health Networks will cover only its commercial members. All require a doctor to diagnose the patient as impotent. ''We have to make safe and efficacious drugs available to those men who have a real medical necessity, men who without Viagra have absolutely no chance of having an erection,'' Kaiser spokeswoman Beverly Hayon said. In the meantime, regulators are beginning to pressure insurers to spell out their coverage plans for Viagra. Because Viagra is a pay-as-you-go drug and not a daily pill, insurers are being forced to answer a squirm-inducing question: How much sex is enough? ''How often is often enough to have sex? I don't know,'' said Art Levin, director of the New York-based Center for Medical Consumers. ''But this drug makes us get into these bizarre questions.'' University of Tennessee urologist Robert Wake notes that some insurers cover a 90-day supply of medically necessary drugs. ''The problem is, what is a 90-day supply?,'' he wondered. United Healthcare covers 8 pills a month, the number used in Pfizer's research. Cigna pays for 6 for patients in its more flexible plans. The company tried to be ''realistic and reasonable'' in deciding how many to cover, spokesman Mark Di Giorgio said. A 48-year-old Memphis, Tenn., patient, who spoke on condition of anonymity, said Prudential paid for the first six pills he used to overcome his diabetes-induced impotence. ''I'm hoping they'll cover me next month,'' he said. ''I'm not going to tell you I'm 19 again, but it works.'' A 52-year-old Atlanta man said he's gladly paying out of his own pocket to use it twice a week. He's not alone. By April 17, after only three weeks on the market, Viagra accounted for 94.4 percent of all impotence drug sales, according to Industry researcher IMS America. And the number of American men seeking any prescription treatments each week has jumped six-fold to 129,422. And with an estimated 30 million men in the United States coping with potency problems, drug industry analysts say Viagra's annual sales could top $1 billion within a few years. Most health insurance plans are still deciding whether to add the potency pill to their list of approved drugs. United Healthcare plans to meet in June to decide. Cigna is giving some patients coverage and requiring a copayment that varies depending on which policy they buy. ''We hope that in a year or so there'll be pretty good coverage,'' Pfizer spokeswoman Marianne Caprino said. Until insurers decide, many managed care patients who are covered will make copayments. At about $10 a pill, Wake said, ''it is fairly affordable for most of the patients who need it, and most of the patients are willing to pay for it themselves if they have to.'' Many insurers, including New York's Empire Blue Cross and Blue Shield, cover at least patients who buy less restrictive plans. Some insurers are just saying no. Aetna U.S. Healthcare, which insures nearly 14 million, is considering coverage but offers none now. Prudential Healthcare is expected to decide within a week whether to cover the drug, but won't pay until then. New York insurance regulators on Tuesday stepped up the pressure, asking 100 insurers for detailed policies on whether and when they'll pay for the Pfizer drug Viagra. Regulators want to know who and how many pills will be covered, and whether insurers are delaying coverage by establishing unnecessary requirements. ''We keep hearing anecdotes (about coverage delays),'' said New York Insurance Superintendent Neil D. Levin, no relation to the consumer activist. ''And we want to make sure that the insurance companies understand our expectations.'' Regulators also want to prevent abuse of the drug by anyone who wants to ''just take it for fun,'' he said. If New York and other states mandate coverage, it could send a ripple of unintended effects through the health care system, consumer activist Art Levin said. ''If you assume that there are only so many dollars around in this era of cost containment, does $10 for a Viagra pill take money away from other health considerations?,'' he said. ''It's a very important issue but on a scale of priorities in public policy I'm not sure it makes the top of the list.''