A United States Cross-Sectional Analysis of Annual Out-of-Pocket Cost Disparities of Erectile Dysfunction Medications

Our objective was to understand the out-of-pocket (OOP) annual costs of phosphodiesterase 5 inhibitors to treat erectile dysfunction through drug coverage programs in the United States.

We compared the annual OOP costs of the lowest and highest routinely prescribed dosage of medications for sildenafil, tadalafil, and vardenafil across widely used pharmaceutical sources. We examined the cost of phosphodiesterase 5 inhibitors under Medicare Part D at (1) hospital retail pharmacies and (2) 3 commercial retail pharmacies (CVS, Walgreens, and Walmart). These findings were compared with discount platforms GoodRx (through CVS, Walgreens, and Walmart), Mark Cuban Cost Plus, and Amazon Pharmacy.

For sildenafil 20 mg, the Part D annual OOP costs including hospitals and retail pharmacies were comparable ranging from $1024 to $1098. The cost at discount platforms was cheaper, ranging from $82 to $275. For sildenafil 100 mg, the hospital-based pharmacies had a median price of $1446, whereas retail pharmacies under Part D ranged from $22,528 to $22,542. Discount platforms were preferred at $89 to $324. For tadalafil 2.5 mg, the Part D groups ranged from $4721 to $4759. The cost of this drug through discount platforms was much lower, ranging from $82 to $312. For tadalafil 20 mg, the cost through Part D ranged from $25,210 to $25,235. The discount platforms were reported to have lower costs ranging from $103 to $496. Vardenafil ranged from $19,015 to $19,039 from Part D groups and $86 to $418 from discount platforms.

There are significant cost savings when using discount platforms, which should be discussed to help patients improve accessibility and compliance with erectile dysfunction medications.