New York, Wisconsin Challenge U.S. Directive on Viagra Payments

New York and Wisconsin health officials refused Friday to go along with a federal directive that state Medicaid programs pay for Viagra, saying they aren’t sure the impotence pill is safe or necessary.

Officials in at least one other state, Michigan, said they are debating whether to ignore the order or brace for what they say would be an annual $14-million bill.

“When you think about all the other things you can do with $14 million, we have to believe that there are better uses for that money,” said Geralyn Lasher, spokeswoman for the Michigan Department of Community Health.

“We’re still looking at our options.”

On Thursday, the Clinton administration directed states to cover the prescription drug when medically necessary. Viagra costs $8 to $10 a pill.

Medicaid, the insurance program for the poor and disabled, is paid for with state and federal dollars.

It isn’t clear what will happen to states that ignore the directive.

Poor people could sue for the drugs, or the federal government could try to withhold Medicaid money from states that refuse to comply.

Viagra is so popular that covering it will cost state and federal agencies $100 million a year, according to the National Governors’ Assn.

“We’re exploring what to do, but our plans are right now that we are not covering this drug,” said Robert Hinckley, spokesman for the New York Health Department.

“The feds are trying to require the states to cover it, and we think it’s the wrong decision. We have significant concerns about the impact this could have on the health of our Medicaid recipients.”

He said New York’s main concern is Viagra’s effect on people with chronic conditions and those taking other medications. He said the state is also worried about Viagra being sold on the street.

More than 30 deaths have been reported to the Food and Drug Administration since Viagra went on the market three months ago.

The maker has warned it should not be taken by people on certain heart medications.

Wisconsin officials said it would cost their state $11.5 million a year to offer Viagra to the poor under Medicaid.

“We just don’t feel this is an expense that taxpayers of Wisconsin should be forced to bear,” said James Malone, spokesman for the Wisconsin Department of Health and Family Services.

In a letter to the governors’ association Thursday, Medicaid administrator Nancy-Ann Min DeParle said Viagra will be closely watched for signs it is being abused. She recommended that states take steps to discourage abuse, such as limiting the number of prescription refills.

DeParle also noted that about 90% of the nation’s 37 million Medicaid beneficiaries are women and children.

“The number . . . that could be diagnosed with erectile dysfunction is very small,” she said.

Before the mandate, leaders from states such as Florida and Utah had argued that Viagra coverage should be an option, not a mandate.

Virginia contended that the drug is not an appropriate use of taxpayer money.