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Does Kaiser Permanente Cover Finasteride?

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At a glance

  • Drug / Finasteride, oral tablet, prescription only [2]
  • 1 mg product / Propecia, approved 12/19/1997 for male pattern hair loss in men only [1]
  • 5 mg product / Proscar, approved 06/19/1992 for symptomatic BPH [3]
  • 1 mg limits / Not indicated for women; efficacy in bitemporal recession not established [2]
  • 5 mg limit / Not approved to prevent prostate cancer [4]
  • Kaiser coverage / Set by your plan's drug list, separately for each strength

What a coverage decision is actually about

Proscar 5 mg was approved on 06/19/1992 [3]. It treats symptomatic benign prostatic hyperplasia in men with an enlarged prostate, and it reduces the risk of acute urinary retention and of surgery including transurethral resection of the prostate and prostatectomy [4]. Propecia 1 mg was approved on 12/19/1997 for male pattern hair loss in men only, with efficacy in bitemporal recession not established and no indication for women [1][2]. Organon holds both applications [1][3].

Finasteride is a prescription-only oral tablet [2]. FDA lists only oral tablets for the drug; no topical or injectable finasteride is FDA-approved [2].

The two strengths are separate questions

Coverage of 5 mg for an enlarged prostate does not by itself settle 1 mg for hair loss: they are different products with different indications and patient groups [1][3]. Propecia is for men only, pregnancy is a contraindication, and women who are or may be pregnant are told not to handle crushed or broken tablets [2]. Proscar's label carries a different limit: it is not approved to prevent prostate cancer [4].

What to ask your Kaiser plan

Ask the plan for each answer in writing:

  • Is finasteride 1 mg on my drug list?
  • Is finasteride 5 mg on my drug list?
  • Is prior authorization required, and what does the request need?
  • Does the plan require a trial of another treatment first?
  • If a request is denied, what reason does the denial give?

Frequently asked questions

Does Kaiser Permanente cover finasteride?
Coverage is decided by your plan's drug list, and each strength is its own question: 1 mg (Propecia) is approved for male pattern hair loss in men [1] and 5 mg (Proscar) for symptomatic BPH [3].
What is the difference between finasteride 1 mg and 5 mg?
Propecia 1 mg was approved on 12/19/1997 for male pattern hair loss in men only, and Proscar 5 mg on 06/19/1992 for symptomatic benign prostatic hyperplasia [1][3]. Both are prescription-only oral tablets [2], and Proscar is not approved to prevent prostate cancer [4].
Does Kaiser cover finasteride for women?
Propecia is indicated for men only, pregnancy is a contraindication, and women who are or may be pregnant should not handle crushed or broken tablets [2]. Whether a plan pays for off-label use in women is a plan decision.
Does finasteride need prior authorization at Kaiser?
Prior authorization rules come from your plan, so ask whether a request is needed for the 1 mg strength, the 5 mg strength, or both [1][3].
Is there a topical finasteride?
FDA lists oral finasteride tablets; no topical or injectable finasteride form is FDA-approved [2].

References

  1. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  2. U.S. National Library of Medicine, DailyMed. Propecia (finasteride 1 mg) tablets, Organon prescribing information. Propecia (finasteride 1 mg) tablets, Organon label
  3. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  4. U.S. National Library of Medicine, DailyMed. Proscar (finasteride 5 mg) tablets, Organon prescribing information. Proscar (finasteride 5 mg) tablets, Organon label
Evidence overview for Does Kaiser Permanente Cover Finasteride?