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Old 08-28-2008, 10:43 PM
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Default PDE-5 Inhibitors Post-Prostectomy

Plans frequently exclude coverage of erectile dysfunction drugs. We've seen an increase in the number of exception requests related to the use of PDE-5 inhibitors for penile rehabilitation post prostectomy. Drugs like Viagra and Cialis are prescribed anywhere from 3-times per week to daily for rehabilitation and prevention of ED. Our review of the current literature found that the theory behind the rehabilitation is based on animal models and that that there is a lack of standard dosing regimens across the published clinical studies. This has led us to deny coverage for this particular indication due to investigational use.

How have others been reviewing and determining these coverage determinations?
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