Cost Analysis of ED Drugs in the United States

[madman]

Abstract

Objective

To perform a cost analysis of generic and brand-name PDE5 inhibitors at different dosages and pharmacies across the US.


Methods

Using an all-payer retail pharmacy claims database, we analyzed prescription drug data for three generics and six brand-name oral PDE5 inhibitors at different dosages across the US chain and independent pharmacies in 2019.


Results

We obtained cash price data from 60,186 pharmacies (35,976 chains and 24,210 independent). The nationwide mean cash price per unit (PPU) ranged from $8.6±5.2 (sildenafil 20mg at chain pharmacies) to $107.1±71 (Adcirca 20mg at independent pharmacies) equal to a 1,145.3% difference. Chain pharmacies provided significantly lower average prices for one brand name and six generic PDE5 inhibitors. Tadalafil PPU was cheaper at higher quantities, however, PPU increased with the quantity prescribed for sildenafil. Looking at the top 10 metropolitan statistical areas, the highest PPUs were observed for tadalafil (Cialis) 10mg and sildenafil (Viagra) 50mg in Atlanta ($67.4±8.7) and Los Angeles ($50.3±24.0), while New York ($9.7±2.6) and Miami Journal Pre-proof3 ($27.9±16.4) had the lowest PPUs for tadalafil (Cialis) 5mg and sildenafil (Viagra) 100mg, respectively.


Conclusion

A substantial variability in PDE5 inhibitor cash prices exists across manufacturer, dosage, quantity, pharmacy type, and location. In addition, the pricing does not necessarily correlate with the regional socioeconomic factors. This highlights the importance of provider awareness and patient counseling on drug price including potentially assisting patients in identifying opportunities for cost savings.




5. Conclusions

Although PDE5 inhibitors have been proven to be an effective class of drugs for ED, their use is sometimes limited due to cost. Using a large nationwide sample of Journal Pre-proof 15 pharmacies, we found substantial variability in PDE5 inhibitor cash prices by retail pharmacy type, manufacturer, dosage, and quantity. We also found the pricing does not necessarily correlate with the regional socioeconomic factors. This highlights the importance of provider awareness and patient counseling on drug price including potentially assisting patients in identifying the most affordable medication regimen. This study could pave the road toward increased affordability, adherence, and inclusion in the use of this highly effective class of medications.

 

[madman]

Table 1 Breakdown of pharmacies that contributed data on PDE5 inhibitors to the study.

 

[madman]

Table 2 Mean (SD) cash PPU for PDE5 inhibitors (brand-name and generic) at different dosages stratified by the pharmacy type. As color goes from blue to red PPU increases.PPU is expressed in US dollar

 

[madman]

Table 3 Average Cash PPU by Quantity Group

 

[madman]

Table 4 Cash PPU of PDE5 inhibitors by the top 10 MSAs. For PPU, as the color goes from blue to red, the mean PPU increases. For socioeconomic variables, a more intense green color is associated with higher numbers. PPUs are expressed in US dollars.

 

[Nelson Vergel]

You can buy PED5 inhibitors with no prescription cheaply here (click banner and use code: EXCELMALE20 for 20 percent off):

Example: 20- 20 mg cialis tablets for $14 after 20% discount.

Credit cards accepted

 

[DorianGray]

They have a veritable cornucopia of erectile products. This one intriguing:
What would the Prozac do?

Malegra Fxt​

Enhances erectile function
Supports sexual performance
Promotes stronger erections
Makes you last longer in bed
Increases confidence and self-esteem
Generic for Viagra ® & Prozac ®​

Malegra Fxt contains Sildenafil & Fluoxetine

 

[Nelson Vergel]

Good combo for ED and to last longer.

 

[Nelson Vergel]

Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), has been shown to be effective in the treatment of premature ejaculation (PE). Studies have indicated that fluoxetine can increase the intravaginal ejaculatory latency time (IELT) and improve ejaculatory control and distress levels for both men and their partners[1][2][3]. The effectiveness of fluoxetine for PE is believed to be related to its ability to counteract the contraction of the vas deferens caused by adrenaline, thereby delaying ejaculation[1][5]. While fluoxetine was not originally designed for this purpose, research has demonstrated its efficacy in treating PE[4]. It is important to note that the use of fluoxetine for PE is off-label, as it is not officially approved by the FDA for this indication[4]. Despite its effectiveness, compliance with fluoxetine therapy beyond 6 months is poor[2].

Sources
[1] Effectiveness and safety of fluoxetine for premature ejaculation - PMC - NCBI Effectiveness and safety of fluoxetine for premature ejaculation: Protocol for a systematic review
[2] Compliance With Fluoxetine Use in Men With Primary Premature Ejaculation - PubMed Compliance With Fluoxetine Use in Men With Primary Premature Ejaculation - PubMed
[3] Tadalafil and Fluoxetine in Premature Ejaculation: Prospective, Randomized, Double-Blind, Placebo-Controlled Study - Karger Publishers Tadalafil and Fluoxetine in Premature Ejaculation: Prospective, Randomized, Double-Blind, Placebo-Controlled Study
[4] Prozac® for Premature Ejaculation: Is It Effective? - hims https://www.hims.com/blog/prozac-for-premature-ejaculation
[5] Effectiveness and safety of fluoxetine for premature ejaculation - Lippincott Effectiveness and safety of fluoxetine for premature... : Medicine