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

To: zurdo who wrote (5064)	8/20/1998 8:44:00 PM
From: Anthony Wong	Respond to of 9523

Viagra Health Coverage Demanded - (LOS ANGELES) -- Consumer advocates say the refusal by some health insurance companies to pay for the popular impotence pill Viagra is an unlawful attempt to boost profits at the expense of patients' health. The California Department of Corporations... which regulates health maintenance organizations (HMOs) in the state... held public hearings this week in Los Angeles and San Francisco to examine whether insurance companies were breaking the law by not paying for the drug. State law dictates that insurers must provide health coverage to patients ''unhindered by fiscal and administrative management.'' Consumer advocates are concerned that if California regulators allow HMOs to exclude certain expensive drugs like Viagra from coverage based on their cost... it could set a precedent for the rest of the country. The hearings were spurred in large part by the recent refusal by the country's largest nonprofit HMO, Kaiser Permanente, to pay for Viagra. dailynews.yahoo.com

To: zurdo who wrote (5064)	8/21/1998 12:15:00 AM
From: Anthony Wong	Respond to of 9523

Calif. Addresses Viagra Coverage Thursday August 20 10:58 PM EDT MICHELLE DeARMOND Associated Press Writer LOS ANGELES (AP) - Viagra may be helping men overcome more than impotence problems. At a hearing Thursday into coverage by health maintenance organizations, a urologist who advised the drug's maker said it is helping men get treatment for conditions that otherwise may not have been diagnosed. ''The existence of a convenient and effective treatment for erectile dysfunction is bringing many men in to see their physicians - and frankly, I doubt that some of these men had been to see a doctor in a long, long time,'' said Dr. Mike Magee, senior medical adviser for Pfizer Inc. Pfizer found that of 1 million men who have come forward with erectile dysfunction, doctors found 30,000 cases of diabetes, 50,000 cases of heart disease, 140,000 cases of hypertension, Magee said. The company said 3.5 million prescriptions, or 30 million tablets, have been dispensed in the four months since the drug was approved. But the safety risks to people with heart problems - along with the $8-$10 cost of a pill - has caused insurers and HMOs to deny or limit coverage. The public hearing before the state Department of Corporations, which oversees the state's managed care industry, is believed to be the first in the nation to address industry coverage of Viagra. The department decided to hold hearings after Kaiser Permanente, the nation's largest nonprofit HMO, said publicly it was not covering the drug because of its cost, agency spokeswoman Julie Stewart said. California law requires HMOs to cover treatment for medical necessities and prohibits the rejection of services for financial reasons. Kaiser has since told the board it was denying coverage for other reasons. Magee told the board that Viagra is a serious treatment for impotence and not a recreation or lifestyle drug. ''Viagra is a remarkable scientific breakthrough ... but it's lost in all the hype,'' he said. PacifiCare said Viagra is available to its clients through a case-by-case approval process. Such reviews are necessary with newly released drugs, the company said. ''We further believe that regulatory or legislative mandates for the coverage of new drugs will threaten pharmacy benefits for Californians,'' said Dr. Cheryl Tanigawa, medical director for Pacificare in Southern California. dailynews.yahoo.com

To: zurdo who wrote (5064)	8/21/1998 12:24:00 AM
From: Anthony Wong	Read Replies (1) \| Respond to of 9523

Calif. consumers demand health coverage of impotence drug Thursday August 20, 11:18 pm Eastern Time By Mark Egan LOS ANGELES, Aug 20 (Reuters) - Consumer advocates said on Thursday the refusal by some health insurance companies to pay for the popular impotence pill Viagra was an unlawful attempt to boost profits at the expense of patients' health. The California Department of Corporations, which regulates health maintenance organizations (HMOs) in the state, held public hearings this week in Los Angeles and San Francisco to examine whether insurance companies were breaking the law by not paying for the drug. State law dictates that insurers must provide health coverage to patients ''unhindered by fiscal and administrative management.'' Consumer advocates are concerned that if Californian regulators allow HMOs to exclude certain expensive drugs like Viagra from coverage based on their cost, it could set a precedent for the rest of the country. The hearings, which began on Tuesday in San Francisco, were spurred in large part by the recent refusal by the country's largest nonprofit HMO, Kaiser Permanente, to pay for Viagra. Oakland, California-based Kaiser, with 9.1 million patients in 19 states and the District of Columbia, said in June that it would not offer Viagra to its members in 1999 because it would cost at least $100 million per year. Many other major health insurers have also refused to pay for the drug on similar grounds. Since its launch in April, almost 3 million U.S. men have taken Viagra, the first oral treatment for impotence, making it one of the most popular prescription drugs ever. ''To do a blanket denial of Viagra, like Kaiser is asking the Department of Corporations to approve, would set a dangerous message and a dangerous precedent that instead of just looking at the medical necessity of the drug they are just doing a blanket denial based on cost,'' Elizabeth Helms of ''Citizens for the Right to Know'' told Reuters. ''It's a violation of (the law.) They cannot use fiscal considerations to reject something when it is a medical necessity,'' she said. ''If they get away with this, where is it going to end?'' Helms said that if regulators allowed insurers to deny coverage of some drugs based on cost, other drugs also could be denied to the detriment of patients' health. She said many insurance companies were slashing benefits in an attempt to boost profits. ''Drugs are being cut from coverage lists and patients are being switched to less effective medications. In many instances life-saving medications, like anti-rejection drugs for transplant patients, have been cut,'' she said. Kaiser's Dr. Sharon Levine told the hearings during Tuesday's session, ''The $7 to $10 (cost) per (Viagra) pill may seem worth it to an individual seeking improved erectile function, but it is our judgment that its social benefit accrued simply does not match the cost.'' Kaiser maintains that paying for drugs such as Viagra would impair its ability to cover other vital heathcare needs. ''We believe that the cost of drugs like Viagra has the ability to undermine the notion of comprehensive health coverage,'' Levine said. Dr. Mike Magee of Pfizer Inc. which makes Viagra, told the hearing on Thursday that Kaiser's figures for the cost of covering Viagra were ''wildly overestimated.'' ''Impotence is a serious medical condition caused by underlying problems that are some of the most chronic and dangerous to the American public,'' Magee added. ''Serious medical conditions deserve coverage.'' Magee said he expected the number of U.S. men taking Viagra to rise to about 4.5 million before demand reaches a plateau. The Department of Corporations will decide before the end of the year whether California's HMOs can exclude Viagra from coverage in 1999. (PFE - news) biz.yahoo.com