This Monday, Dec. 4, 2017 photo shows Pfizer's Viagra, left, and the company's generic version, sildenafil citrate, at Pfizer Inc., headquarters in New York. (AP Photo/Richard Drew)

By Dorothy Mills-Gregg

Tricare would only cover the generic versions of Viagra and Cialis under a new policy passed by a Defense Health Agency (DHA) panel Wednesday.

The DHA Beneficiary Advisory Panel, which provides advice and recommendations on what Tricare should cover, voted 6 to 2 for a policy that would also require physicians to prescribe new users generic Viagra before trying generic Cialis to treat erectile dysfunction.

Viagra, generic name sildenafil, tablets are for short-term use, while Cialis, or tadalafil, is considered "long-acting" and can be used to treat an enlarged prostate.

The panel's discussion was mostly about how physicians choose which drug to prescribe first.

"But [physicians] said they need them both," said Charles Hostettler, a panel member representing AMSUS, an organization for military health care professionals, "and yet you're forcing them to use the short-acting first in all cases and which to me just seems to be a little bit strange."

The recommendation to change Tricare's coverage came from the Department of Defense Pharmacy & Therapeutics Committee, which voted last year to modify it after determining that generic and brand-name erectile dysfunction drugs have the same efficacy.

If approved, this policy would also move erectile dysfunction drugs Stendra, Staxyn, Levitra and all their generics to Tier 4 status, meaning they won't be covered under Tricare.

Under the policy change, men who are more than 40 years old will no longer need prior authorization from their doctor for Tricare to cover generic drugs to treat erectile dysfunction; those younger than 40 or who have enlarged prostates will still need authorization.

The recommendation now goes to the DHA's deputy director, who will review and sign off on the new policy on behalf of the DHA director.