After being rejected twice by the Food and Drug Administration, the sexual dysfunction medication ADDYI, also known as the ‘female Viagra,’ was approved for sale in October 2015.
That said, getting an insurance company to pay for it is an entirely new obstacle for interested users. ADDYI discounts are available for eligible patients who cannot afford the out-of-pocket costs for their medications. And today, we will tell you why insurers are not covering ADDYI drugs.
What Do Insurance Companies Say About ADDYI?
Not long ago, the Food and Drug Administration (FDA) approved a new medication for the treatment of female sexual dysfunction. However, many major health providers are choosing not to cover ADDYI, leading to frustration in many women who could otherwise benefit from it.
Taking Viagra has become a widely accepted practice for men with erectile dysfunction. So when the new “female Viagra” drug, ADDYI, became available, many women expected that their insurance companies would cover the cost, no questions asked.
However, insurance companies have been quick to point out that there are significant differences between the two drugs. For one, Viagra is taken as needed, while ADDYI must be taken daily. Additionally, the side effects of ADDYI are much more serious than those of Viagra and can include dizziness, fainting, and low blood pressure.
As a result, most insurance companies require women to see a psychiatrist before they will cover the cost of the drug. Some experts say that the insurance companies’ cautious approach is understandable, given the potential risks associated with the drug.
What Drug Law Allows?
The law that regulates insurance companies’ prescription drug coverage is called the Patient Protection and Affordable Care Act (reform law in 2010), or Obamacare. Part of the law requires insurers to cover all “essential health benefits,” which includes prescription drugs.
However, there is a loophole in the law that allows insurance companies to refuse to cover certain drugs, including ADDYI. The law states that insurers can refuse to cover a drug if it is “not medically necessary.”
In other words, if the insurance company believes that the drug is not effective or that there are safer and cheaper alternatives available, they can choose not to cover it. As a result, many women have been left without coverage for ADDYI and have had to pay for the drug by themselves. While it may seem like the law protects women’s access to essential health benefits, in reality, it leaves many women without coverage for the drugs they need.
Reasons Insurance Companies Won’t Cover ADDYI
Many insurance companies have refused to pay for ADDYI, stating the company guidelines that they require users of this expensive drug to go under a psychiatrist consultation before they consume this.
When questioned about ADDYI refusals, a spokesperson for the insurance industry stated that ADDYI is not very effective and can cause side effects, as demonstrated by a number of studies.
This justification does not sit well with sexual dysfunction specialists.
They claim that the FDA ruled last year that the prescribed medication ADDYI is safe and effective. The doctors add that now the drug is not effective for all women, but it is effective for some. 8 to 13 percent of women who tried the drug reported that it helped them with their sexual-dysfunction issues.
Depending on the pharmacy that you go to, the oral tablet form of ADDYI with a dosage of 100 mg will run you approximately $960 for a supply of 30 tablets. But you can avail of an ADDYI discount in a variety of formats, including printable coupons, rebates, savings or copay cards, trial offers, and free samples.
Why Does The Insurance Industry Think ADDYI Isn’t Very Effective?
According to the Food and Drug Administration (FDA), ADDYI is the first and only drug approved to treat low sexual desire in premenopausal women. However, due to its potential side effects, insurers are not required to cover ADDYI.
The most common side effects are fatigue, nausea, dizziness, sleepiness, and impaired ability to drive or operate heavy machinery. In addition, ADDYI can interact with alcohol, birth control pills, and certain other medications.
As a result, women who take ADDYI must be sure to talk to their doctor about all of their medical conditions and medications before starting treatment.
FDA Reviews On ADDYI
Prior to 2015, there were no treatments that had been approved by the Food and Drug Administration (FDA) to address sexual desire disorders that were prevalent among women in the United States.
The only commercially available treatment for the condition in the European Union was the transdermal testosterone patch, Intrinsa (Warner Chilcott UK Ltd.), but its marketing authorization was revoked in 2012.
However, the U.S. Food and Drug Administration (FDA) approved ADDYI in 2015, making it the first FDA-approved treatment for low sexual desire in women. FDA has required that the manufacturer of ADDYI provide patient education materials to healthcare providers and patients.
The FDA’s review also found that the risks associated with ADDYI are similar to those associated with other treatments for low sexual desire in women. The most common side effects of ADDYI are fatigue, sleepiness, nausea, and dizziness.
These side effects typically occur when ADDYI is first started and usually go away with continued use. Women who experience these side effects should talk to their healthcare provider about whether they should continue taking ADDYI.
Pharmaceutical companies have been eager to market ADDYI as a new drug for women with low sexual desire. However, insurers are not convinced that the benefits of the drug outweigh its risks and costs.
The FDA has approved ADDYI, but it is still unclear whether or not the drug is actually effective. It is important to note that there are many other treatments available for low sexual desire in women, including counseling and lifestyle changes.
If you are experiencing problems with your sex life, it is best to consult with your doctor to find a treatment that works for you.