Imagine not being able to afford one of life's great pleasures, sex.
That's true for many older couples, doctors say. Soaring prices for prescription medicines for impotence and other problems have put the remedies out of reach for some, Viagra and Cialis costs has triple their 2010 list prices. The new female Viagra, a daily pill for low sex drive called Addyi, costs $800 per month.
“Without insurance coverage, many of them don't get past the pharmacy counter once they see the price,” says Sheryl Kingsberg, a behavioral psychologist and researcher at the University Hospitals-Cleveland Medical Center.
What people actually pay out of pocket varies. Some plans don't cover any, arguing they're not medically necessary. Many require steep copayments or limit the number of impotence pills per prescription. “Once you get to a certain price point, sex becomes a financial decision,” says Dr. Elizabeth Kavaler, a sexual dysfunction specialist at New York's Lenox Hill Hospital.
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Five of six specialists interviewed by The Associated Press say patients have told them they've given up sex because of the cost. Patients unwilling to forego sex, doctors say split pills or otherwise ration medicines, beg for scarce samples or seek copay discount coupons. Men with enlarged prostates can request Cialis because it's also approved for that condition, usually with insurance coverage. Some women make do with over-the-counter lubricants.
Others take a big risk buying herbal Viagra at gas stations or ordering Viagra online from pharmacies that likely sell counterfeit drugs made in poor countries, says Dr. Irwin Goldstein, director of San Diego Sexual Medicine.
Dr. Nachum Katlowitz, head of urology at New York's Staten Island University Hospital, offers an alternative costing about $1 per pill at some pharmacies. The active ingredient in Viagra, sildenafil is also in Pfizer's now-generic blood pressure pill Revatio but at one-fifth the dose. One of his patients a 62-year-old hospital technician, takes several of the blood pressure pills before sex.
“I couldn't afford it if I had to pay for Viagra,” says Robert, he experienced modest improvements and says he enjoy sex twice as often.
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A generation ago, long-married couples accepted their sex lives trailing off with age, key hormone levels drop with age, reducing sex drive and causing problems such as impotence and vaginal dryness, which often makes intercourse painful. Today, midlife divorce is more common, divorced or widowed men and women often seek new partners, and sex becomes important again.
Now, a little relief is coming. Late next year, Viagra and Cialis will get at least one generic competitor costing slightly less, prices will plunge later when more generics reach the market. For women, an Addyi rival is in late-stage testing. A few other products now have generic versions and other options are in development.
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