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 | With Insurance: Doctor Visit co-pay + Prescription co-pay Usually $10-$35 Per Month |
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 | Without Insurance: Doctor Visit + Around $90 Per Month |
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 | High: Surgery Can Run $10,000-$30,000; Insurance Co-Pays Can Be $1,000-$3,000 |
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| | | Men with erectile dysfunction have trouble getting and maintaining erections adequate for intercourse because of decreased blood flow or nerve damage to the penis, but they have normal sensation and usually can achieve orgasm. Erectile dysfunction can be caused by vascular problems, chronic illnesses such as diabetes, surgery or medications. Most patients treat ED with medication, but for the approximately 30 percent of men for whom pills do not work or for men who do not tolerate the side effects, a vacuum pump is an option. Some men who are not satisfied with the vacuum pump or find it inconvenient opt for the more invasive penile implant surgery. | | |
| Typical costs: | - For patients not covered by health insurance, erectile dysfunction treatments usually cost $9 to $10 per pill -- a pill is taken only before intercourse -- or $90 to $100 for a bottle of 10 pills that could last a month, depending on the frequency of use.
- A vacuum pump costs $200 to $600. Hand-operated pumps are usually at the lower end of the range, while battery-operated pumps are at the higher end.
- Penile implant surgery costs between $10,000 and $30,000, depending on the doctor and type of implant used. Semi-rigid implants are less expensive than inflatable implants.
- Erectile dysfunction treatments, including pumps and surgery, often are covered or partially covered by health insurance plans after a doctor's diagnosis of erectile dysfunction. However, some plans exclude erectile dysfunction treatments or place a dollar limit on coverage.
- For patients covered by health insurance, the typical out-of-pocket cost for drugs is a prescription drug co-pay that can range from $10 to $30. For a pump, it is a co-pay of up to 20 percent, or $40 to $120. And for surgery, the out-of-pocket expense would be a co-pay or coinsurance of 10 percent that could cost between $1,000 and $3,000. A Medicare recipient's co-pay would be a little over $800.
What should be included: | - The National Institutes of Health offers an overview of erectile dysfunction and its treatments.
- Drugs called phosphodiesterase (PDE) inhibitors -- known by the brand names Viagra, Levitra and Cialis -- are taken orally an hour before sexual activity. The drugs enhance the effect of the chemical nitrous oxide, allowing increased blood flow to the penis and improving response to sexual stimulation. They can be taken once a day.
- As an alternative treatment, a vacuum pump works by making blood flow into the penis. WebMD has an overview of vacuum pumps.
- For a surgical implant, which usually is considered a secondary treatment to be considered if drugs or other measures do not provide satisfactory results. WebMD has an overview of penile implants.
Additional costs: | - An appointment with a family doctor or urologist will be needed. Or, some men bring up the topic at their annual check-up.
- Because erectile dysfunction can cause issues in a relationship, experts sometimes recommend couples' counseling.
- Implants generally have a lifespan of eight to 10 years before parts need to be replaced. Insurance coverage of repairs and replacement parts varies.
Discounts: | - Viagra offers a Viagra Value Card that gives you every fourth prescription refill free. Cialis offers a free trial and to pay for a free trial of a competing medication if you are not satisfied with Cialis. And Levitra offers three pills free when you fill a prescription.
Shopping for erectile dysfunction treatments: | - Because there are many possible causes for erectile dysfunction, which is not considered a normal part of aging, though it is more common as men age, it is important to see your regular doctor, and possibly a specialist, for a diagnosis and treatment plan. The American Urological Association has a urologist locator by zip code. If seeing a specialist, check to make sure the doctor is certified by the American Board of Urology. Doctors can sometimes improve the problem by treating an underlying cause.
- If considering drugs as treatment, you should know that the three FDA-approved PDE inhibitors, Viagra, Levitra and Cialis, work through a similar mechanism, but have differences in how quickly they start working and how long they last. Viagra and Levitra both start working in about 30 minutes; Viagra lasts four hours and Levitra, five. Cialis starts working in 15 minutes and can last up to 36 hours. UrologyHealth.org offers a comparison and detailed information. If one of the brand does not work well for a patient, the other ones probably will not either. These drugs are effective for about 70 percent of patients. It is a good idea to buy only name-brand pills from reputable, U.S.-based pharmacies. Generic versions are not FDA-approved and are often bootlegged from other countries and could be unsafe. (The patent for Viagra will expire in 2010, at which point legitimate generic versions will become available in the United States.)
- Side effects of PDE inhibitors can include: headaches, upset stomach or heartburn, nasal congestion, a flushed feeling, changes in vision with color or glare, and back pain. You should not take PDE inhibitors if you: take alpha-blockers for blood pressure or prostate problems; take nitroglycerin or a long-acting nitrate for chest pain; have had a heart attack, stroke or life-threatening arrhythmia in the past six months; have uncontrolled high or low blood pressure or experience chest pain during sex.
- Possible complications of penile implants include infection, for which risk is increased in men with diabetes mellitus, and mechanical problems. It is important to know that having an implant can destroy the ability for a man to ever again have a "natural" erection.
- It is important to use only a vacuum device that has been approved by the U.S. Food and Drug Administration. Some non-FDA-approved devices available on the internet can cause damage to the penis. Side effects of vacuum pumps can include bruising or, if left on longer than 30 minutes, tissue damage. The devices should not be used by men who might have a congenital bleeding disorder or any condition that makes them more likely to suffer priapism, a prolonged and possibly painful erection that can last hours or even days. Examples of such conditions include sickle cell anemia and some types of leukemia.
- Some men seek alternative erectile dysfunction treatments, such as vitamins, herbs or acupuncture. WebMD has a guide to using alternative treatments safely.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Article updated January 2009 |
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