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Does State Medicaid Cover Finasteride?

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At a glance

  • Coverage / Decided by each state program, so ask about each strength separately
  • Prescription status / Prescription-only (Rx) [1][2]
  • 1 mg tablet / Propecia, approved 12/19/1997, male pattern hair loss in men only [1]
  • 5 mg tablet / Proscar, approved 06/19/1992, symptomatic BPH [2]
  • Forms on the FDA record / Oral tablets (Propecia 1 mg, Proscar 5 mg) [1][2]
  • Pregnancy / Contraindicated; label says do not handle crushed or broken tablets [3]

How coverage is decided

Whether finasteride is paid for depends on the state program doing the paying: its formulary, its prior authorization and step therapy rules, and how it defines medical necessity. This page does not list state-by-state policies. What follows is the drug itself, because that is what any coverage decision is about.

Two strengths, two approvals, two indications

The 1 mg tablet is Propecia (NDA 020788), first approved 12/19/1997 and held by Organon. It is indicated for male pattern hair loss (androgenetic alopecia) in men only; efficacy in bitemporal recession has not been established, and it is not indicated for women [1].

The 5 mg tablet is Proscar (NDA 020180), first approved 06/19/1992. It is indicated for symptomatic benign prostatic hyperplasia in men with an enlarged prostate, to improve symptoms, reduce the risk of acute urinary retention and reduce the risk of surgery including TURP and prostatectomy. It is also indicated with the alpha-blocker doxazosin to reduce the risk of symptomatic progression. The label states it is not approved for the prevention of prostate cancer [2].

Who the labels say the drug is for

Propecia is not indicated for use in women, and pregnancy is a contraindication. The label states that finasteride may cause abnormalities of the external genitalia of a male fetus, that women who are or may be pregnant must not take it, and that they must not handle crushed or broken tablets; intact coated tablets prevent contact with the active ingredient [3].

Proscar carries the same pregnancy contraindication and is not indicated for use in females or pediatric patients [4].

Frequently asked questions

Does state Medicaid cover finasteride?
That is decided by each state program's drug list and rules. Ask about the 1 mg and 5 mg tablets separately, since Propecia 1 mg is approved for male pattern hair loss in men and Proscar 5 mg for symptomatic BPH [1][2].
Is finasteride a prescription-only drug?
Yes. Both products are listed as prescription products: Propecia 1 mg for male pattern hair loss in men only, and Proscar 5 mg for symptomatic BPH [1][2].
Do the 1 mg and 5 mg tablets share one approval?
No. They are separate new drug applications: Proscar 5 mg was first approved on 06/19/1992 for symptomatic BPH, and Propecia 1 mg on 12/19/1997 for male pattern hair loss [1][2].
Is finasteride approved for women?
No. Propecia is indicated for male pattern hair loss in men only and not indicated for women, and pregnancy is a contraindication. The label says women who are or may be pregnant must not take finasteride or handle crushed or broken tablets [1][3].
Does Proscar prevent prostate cancer?
No. The Proscar label states it is not approved for the prevention of prostate cancer, and it reports Gleason score 8 to 10 cancer in 1.8% of men on finasteride versus 1.1% on placebo in the 7-year Prostate Cancer Prevention Trial [4].

References

  1. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  2. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  3. U.S. National Library of Medicine, DailyMed. Propecia (finasteride 1 mg) tablets, Organon prescribing information. Propecia (finasteride 1 mg) tablets, Organon label
  4. U.S. National Library of Medicine, DailyMed. Proscar (finasteride 5 mg) tablets, Organon prescribing information. Proscar (finasteride 5 mg) tablets, Organon label
  5. Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998;39(4 Pt 1):578-89. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group
Evidence overview for Does State Medicaid Cover Finasteride?