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• W77428909 abstract "With the recent discussions, about Medicaid coverage for lifestyle-enhancement drugs, POLICY & PRACTICE talked with Garth L. Splinter, M.D. Dr. Splinter is chief executive officer of the Oklahoma Health Care Authority. With a masters in business administration from Harvard University, Dr. Splinter has worked in industry for both large and small companies. He entered the University of Oklahoma's medical school in 1980 and earned his medical degree in 1984. He eventually joined the university's faculty as an assistant professor at the Health Sciences Center in 1987, after completing his family practice residency training program. In addition to his role as an assistant professor at the center, Dr. Splinter served as director of the university's Health Sciences Center for Health Affairs and Rural Health Programs. He also served as assistant commissioner for health care reform at the Oklahoma State Health Department. During Governor David Walters' term, Dr. Splinter served as special assistant on health care issues. In addition, he was past chair of the Commission on Oklahoma Health Care, medical director for the Employees Group Insurance Board, and principal investigator for the Robert Wood Johnson Grant of State Initiatives on Health Care Financing Reform. PP it's been of great interest in general, and has gotten much attention from comedians. Second, and more important, is that its use addresses the classic area of allocation of scarce resources. So its use raises questions about what the limits of coverage should be. P&P: There are other impotence drugs that have been available for some time. Why is Viagra superior to the other impotence drugs? SPLINTER: Compared to some of the other means of treating impotence, Viagra is an oral medication and is much easier to use. It appears to be more efficacious. There are, however, other methods of treating impotence, including implants and injections. P&P: That brings me to my next question: what are some of the clinical concerns about its use? SPLINTER: The clinical concerns are still developing. As with any new drug, there are side effects, especially when interacting with other medications. For instance, people who take nitrates to treat a heart condition should not take Viagra. There's also some developing concern about how it [Viagra] may interact with other medicines that are used to treat hypertension or high blood pressure. I don't think Viagra's side effects are that much different from other medicines that are on the market. With large-scale use, you see interactions that are less frequent than what would necessarily be shown by clinical trials. It's just that Viagra is such a highly visible drug so it's gotten a lot more attention. P&P: There are reports that some women have used Viagra, although it is actually being prescribed for men. If the Food and Drug Administration (FDA) approved the use of Viagra for women, what would be your concerns from a physician's viewpoint or from a Medicaid administrator's viewpoint? SPLINTER: It would be the same as it is now. If the FDA approved it for women, it would be for an indication other than for penile erectile dysfunction, such as libido enhancement. I would have the same concern as we do for the use of men: is it an appropriate use of Medicaid resources to cover that? P&P: Some states have chosen not to cover Viagra. To your knowledge, has there been any action by the federal government to challenge the actions of those states? SPLINTER: I'm not aware of any. Our state is one that has chosen not to cover it. …" @default.
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• W77428909 title "A Conversation with GARTH L. SPLINTER" @default.
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