editorial comment Starnge that the substance of choice of old men is not only legal, but is now subsidized......

Sexual performance drugs such as Viagra will be covered in Medicare's new prescription drug program, a lifestyle rather than lifesaving benefit that conservatives and watchdog groups say the government shouldn't provide.

Prescriptions for Viagra, Levitra, Cialis and other drugs that are used primarily to treat erectile dysfunction will be tightly controlled under the coverage that begins Jan. 1.

"The law says if it's an FDA-approved drug and it is medically necessary, it has to be covered," said Gary Karr, spokesman for the Centers for Medicare and Medicaid Services, which administers the health insurance program for older Americans.

Clinical experts said that from a medical perspective, the decision makes sense - and follows the practices of private insurance plans and other government health care programs.

"These are drugs that treat a condition that compromises the quality of life, but doesn't threaten life," said Dr. Ira Sharlip, a urologist and professor at the University of California, San Francisco.

"But there are many drugs that are approved for quality-of-life indications," he continued. "It wouldn't be right to single out [impotence drugs] as frivolous when there are so many others in the same category," including prescription drugs for indigestion or mild pain.

Overall, according to a spokesman for Pfizer Inc., which makes Viagra, men ages 60 to 69 account for about 22 percent of prescriptions for the medicine, while those 70 and over account for about 17 percent. More than 15 million American men have tried Viagra since it was introduced in 1998.

Critics say the law puts Congress, not medical professionals, in the position of deciding which drugs should be covered. "You cannot have a universal entitlement like this without extreme micromanagement," said Robert E. Moffit, a health care analyst at the Heritage Foundation.

"Members of Congress, frankly, are not competent to make these decisions," he added. "Micromanagement will institutionalize incompetence."

Los Angeles Times, Associated Press

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