ED medication cost

The short answer

In the 16 September 2026 CMS NADAC file, one labelled starting dose of generic sildenafil — a 50 mg tablet — costs a retail pharmacy $0.10577 on invoice. That is the floor for erectile-dysfunction treatment in the United States, and almost nothing else on the shelf is near it. The same file prices a 10 mg generic vardenafil starting dose at $1.91, which is 18.1× as much, and the only generic avanafil presentation it prices at all — the 200 mg tablet — at $49.48, which is 468× as much. Brand is dearer again: VIAGRA 100 mg is $83.63 a tablet, 655× its generic. Our directory records 10 priced ED listings from 8 providers, 7 of them quoted per dose or per pack and 3 per month, and exactly 1 of the 10 names both a molecule and a strength. None of these are prices you can pay. What they establish is that the cheap answer exists and is federally published, and that the thing separating you from it is which of the four molecules ends up on the prescription.

The figures, and where each one comes from

What this page will not tell you

Each of these is missing because it could not be sourced, not because it was overlooked. Where a figure is unpublished, this page says so rather than estimating it.

• What your pharmacy will charge you in cash for a tablet.

  NADAC is an acquisition cost — what the pharmacy paid, before its dispensing fee and before margin. No federal or commercial dataset publishes what pharmacies then charge a cash payer; the same NDC is quoted severalfold apart by two counters in the same town, and an average of unpublished numbers is not a figure. Ring two pharmacies and ask for the cash price on the strength your prescription names.

• A price for a labelled 100 mg avanafil starting dose.

  Section 3 of the STENDRA label supplies 50 mg, 100 mg and 200 mg tablets and section 2.1 says "The recommended starting dose is 100 mg", so the tablet exists. The 16 September 2026 NADAC file prices only the 200 mg presentation. Halving it is not available either: the CIALIS label opens its dosage section in bold with "Do not split CIALIS tablets; entire dose should be taken", the avanafil label says nothing about splitting at all, and FDA's position is that where a label is silent it "has not evaluated it to ensure that the two halves of a split tablet are the same in weight or drug content". So the cell reads "not priced" rather than half of $49.48.

• An acquisition cost for Levitra or Stendra.

  Neither brand has a row in the 16 September 2026 file. A brand with no NADAC row is not thereby unavailable or free — it means no surveyed retail community pharmacy reported buying it in the period, which is a fact about the survey and not about the shelf. We do not carry a rate forward from an older release to fill the space, and we do not substitute the generic rate and relabel it.

• A per-dose figure for any monthly ED subscription.

  3 of the 10 recorded listings are quoted per month and not one of them states how many doses a month is included. Dividing a monthly by an assumed frequency would invent the assumption and then present the result as a price. The monthly figures are printed as monthlies, with the column that would hold a multiple saying why it is empty.

• A published rate for the chewable, sublingual and orally dissolving ED products.

  Those are compounded or combination preparations rather than the approved tablets the four labels describe — one recorded listing adds L-arginine and oxytocin to the PDE5 inhibitor. A compounded preparation has no NDC, therefore no NADAC row, and no approved counterpart at the same strength to price it against. They appear in the table with the price the provider states and no comparison beside it.

• A GoodRx or discount-card price.

  Those resolve per ZIP code, per pharmacy and per card, and change without notice. A single number printed here would be wrong for most readers on the day they read it and stale by the following week. We print none, and we do not average them into one.

• What ED treatment costs with insurance.

  This page is the cash case. Coverage for PDE5 inhibitors is patchy by design — many commercial plans exclude them outright or cap the quantity per month, and the cap rather than the price is usually what decides the bill. None of that is a national number and we will not invent an "average copay" for a benefit many readers do not have.

Why the molecule matters more than the brand

CMS contracts a monthly survey of the invoice prices retail community pharmacies actually pay and publishes the average weekly, per NDC, with a methodology document. It is not a consumer price and is not meant to be one — it is what the pharmacy paid, which is why it is the only number in this market that can be checked. In the 16 September 2026 file a generic sildenafil 50 mg tablet is $0.10577 and a generic tadalafil 5 mg tablet is $0.10216. At those rates a tablet costs about a tenth of what a stamp does.

The story every other ED cost page tells is brand against generic, and it is a real story: VIAGRA 100 mg is 655× its generic in the same file, and CIALIS 5 mg is 90.2× its own. What that story misses is that the four molecules are not interchangeable on price either. Generic vardenafil at its labelled 10 mg starting dose is 18.1× the sildenafil starting dose, and the only priced generic avanafil tablet is 468× it. Both of those are generics. Nobody is charging a brand premium; the market for those two molecules is simply thin, and a thin market does not produce a cheap generic.

Which makes the once-daily line the one worth knowing. Tadalafil is the only one of the four whose label carries a licensed once-daily regimen, and a year of 5 mg tablets every day is $37.29 of drug at acquisition — less than three VIAGRA tablets. Whether daily or as-needed dosing suits you is a clinical question with two separate labelled regimens behind it and it is not answered by a price; /tools/ed-cost-per-dose works out where the two lines cross for a stated frequency. This page only records that the daily line starts very low.

None of which is what you will be billed. Our directory records 10 priced ED listings and they arrive in five different units — per dose, per use, per month, per pack of ten, and "from" a figure — with 1 further provider stating no price at all until an intake quiz is completed. Exactly 1 of the 10 names both the molecule and the strength you would be getting. That is the real obstacle to comparing ED prices, and it is not solved by finding a better dataset, because the missing information is missing from the listings themselves.

What one labelled dose costs at the published acquisition rate

Every dose the four labels name for as-needed use, composed from whole generic tablets at the rates in the 16 September 2026 CMS NADAC file. The last column reads each against $0.10577, the generic sildenafil 50 mg starting dose.

Not what you will be charged: acquisition costs, before any dispensing fee, pharmacy margin, prescriber or shipping. Whole tablets only — no dose here is made by halving a bigger tablet, because the CIALIS label forbids splitting outright and the other three labels are silent, which FDA does not treat as permission. Three priced presentations are deliberately absent from this table: SILDENAFIL 20 MG TABLET at $0.05101 per tablet; SILDENAFIL 10 MG/ML ORAL SUSP at $0.27273 per mL; VARDENAFIL HCL 10 MG ODT at $24.87 per tablet. The reasons are the pulmonary-hypertension indication, a non-tablet form, and a dosage form whose own label says it is not interchangeable with the film-coated tablet.

Brand against generic, same molecule, same strength, same week

Every brand row in the 16 September 2026 file paired with the generic of the same molecule and strength in the same file. The gap is the acquisition cost of the brand name.

CMS publishes its own corresponding-generic figure on each brand row, and it matches the generic rows transcribed here to the fifth decimal place — an independent audit of the transcription rather than our own arithmetic. One rate is older than the rest: CIALIS 10 MG TABLET carries explanation code 4, "The NADAC was carried forward from the previous file.", and an effective date months before the others. Levitra and Stendra have no row in this file at all, so no gap can be shown for vardenafil or avanafil.

What our directory records providers listing

Each recorded ED listing exactly as the provider states it. The third column is what the listing itself specifies; the fourth compares it to the published rate only where the listing supplies enough to make the comparison honest.

Ordered by cost per dose where the unit allows one to be worked out, because that is how a price is looked up; it is not an order of merit and these are not all the same product. BraveRX is in the directory and absent from this table: the record states "Pricing shown after the intake quiz" where a price would be, and a listing that states no price is left out rather than guessed at. A consultation fee is charged separately by at least one provider here and is not folded into any figure in this table. Verify the current price with the provider before you buy.

Frequently asked questions

How much does ED medication actually cost?

The drug itself costs almost nothing: in the 16 September 2026 CMS NADAC file a generic sildenafil 50 mg tablet is $0.10577 at pharmacy acquisition and a generic tadalafil 5 mg tablet is $0.10216. What you pay is set by everything around it — the prescriber, the pharmacy's dispensing fee and margin, and the platform. The per-dose listings our directory records run $1.60 to $15.00, which is 15.1× to 142× the acquisition figure.

Is generic always cheaper than brand for ED drugs?

Cheaper than the matching brand, always, and by a lot — the four brand-to-generic gaps in this file run from 90.2× to 655×. But "generic" is not a price band. Generic vardenafil at its labelled 10 mg starting dose is $1.91, which is 18.1× a generic sildenafil starting dose, and the only priced generic avanafil tablet is $49.48. Both are generics with no brand premium on them at all. Which molecule you are prescribed moves the drug cost further than whether it is branded.

Why is there no price for a 100 mg avanafil tablet?

Because the 16 September 2026 NADAC file does not carry one. The STENDRA label supplies 50 mg, 100 mg and 200 mg tablets and names 100 mg as the recommended starting dose, so the product exists — no surveyed pharmacy reported buying it in the period, which is a fact about the survey rather than the shelf. We will not halve the 200 mg rate to fill the gap: no PDE5 label permits splitting, the CIALIS label prohibits it in bold, and FDA says a silent label means the halves have not been evaluated for equal drug content.

Can I split a tablet to halve the cost?

Not on any of these four. CIALIS opens its dosage and administration section, before naming a single dose, with "Do not split CIALIS tablets; entire dose should be taken", and six generic tadalafil labels carry the same sentence. The sildenafil, vardenafil and avanafil labels say nothing about splitting — and silence is not permission: every SPL read for this site declares the FDA structured Score characteristic as one piece, meaning no score line, and FDA tells patients that where a label carries no splitting information it has not evaluated whether the two halves contain the same amount of drug.

Why can you not tell me what a monthly ED subscription costs per dose?

Because the listings do not say how many doses a month is included. 3 of the 10 priced ED listings our directory records are quoted per month and none of them states a quantity. Any per-dose figure would come from an assumed frequency we made up, and the assumption would then be invisible inside the number. The monthly figures are printed as monthlies and the comparison column says what is missing.

Is once-daily tadalafil cheaper than taking one when you need it?

At acquisition, a year of 5 mg once-daily generic tadalafil is $37.29 of drug — $0.10216 a day, every day. Whether that beats as-needed dosing depends entirely on how often "as needed" is, and that crossing point is arithmetic rather than advice: /tools/ed-cost-per-dose computes it for a frequency you supply. The clinical question is separate and is not a cost question — the two regimens are licensed differently and do different things.

Why do the ED prices on different websites look nothing alike?

Largely because they are not the same unit. Across the 10 priced listings in our directory there are five: per dose, per use, per month, per pack of ten tablets, and a "from" figure that is the floor of an unstated range. On top of that, only 1 listing names both the molecule and the strength. A quoted figure that does not say sildenafil or tadalafil, 25 mg or 100 mg, once or eight times a month, is not comparable to any other quoted figure, and no amount of arithmetic fixes that.

What does this page not tell me?

Seven things, printed above rather than quietly omitted: what your pharmacy will charge in cash, a price for a labelled avanafil starting dose, an acquisition cost for Levitra or Stendra, a per-dose figure for any monthly subscription, a rate for the compounded chewable and dissolving products, a discount-card price, and what any of it costs with insurance. Each is missing because it could not be sourced, and each entry says which dataset does not exist.

Sources

1. [1]
   CMS / Medicaid.gov — Retail Price Survey, the programme behind the NADAC files

   These pricing files, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States.

   Retrieved 2026-09-20

2. [2]
   NADAC weekly reference file, 16 September 2026 — the PDE5 rows charted above (CSV, ~97 MB; the quoted line is the widest brand-to-generic gap in it)

   VIAGRA 100 MG TABLET,00069422030,83.63291,08/19/2026,EA,C/I,N,1,B,0.12762,08/19/2026,09/16/2026

   Retrieved 2026-09-20

3. [3]
   STENDRA (avanafil) tablets prescribing information, Metuchen Pharmaceuticals, NDA 202276 — sections 2.1 and 3, for the starting dose that has no published rate

   The recommended starting dose is 100 mg. STENDRA should be taken orally as needed as early as approximately 15 minutes before sexual activity.

   Retrieved 2026-09-20

4. [4]
   CIALIS (tadalafil) tablets prescribing information, Eli Lilly and Company, NDA 021368 — section 2, the sentence that opens the dosage section

   Do not split CIALIS tablets; entire dose should be taken.

   Retrieved 2026-09-20

5. [5]
   Alpha Health Finder online ED provider directory — the listings charted above, recorded by us from each provider

   Strut Health "Sildenafil (ED)" $1.60/dose through Roman "ED Treatment" $15/dose, plus 3 monthly plans and 1 provider with no stated price, as recorded in src/data/online-providers.ts

   Retrieved 2026-09-20

6. [6]
   FDA — Tablet Splitting, the agency guidance on tablets whose labels carry no splitting information

   If a tablet does not include such information in the label, FDA has not evaluated it to ensure that the two halves of a split tablet are the same in weight or drug content or work the same way in the body as the whole tablet.

   Retrieved 2026-09-20

Next steps

• ED cost per dose calculator
• Generic vs brand sildenafil
• ED medication comparison chart
• Sildenafil vs tadalafil
• All ED providers

Other cost references

• TRT cost without insuranceThe published floor for testosterone cypionate, the listed ceiling for online TRT, and the gap between them.
• Semaglutide cost without insuranceThe published acquisition floor for every approved semaglutide product, the recorded telehealth ceiling, and the gap that runs the wrong way.
• Tirzepatide cost without insuranceThe published acquisition floor for every approved tirzepatide presentation, the same injection priced twice, and the recorded telehealth ceiling.
• Finasteride costThe published floor for finasteride, the brand rate beside it, and what eight recorded hair-loss plans actually charge.
• Testosterone lab panel costThe published federal rate for each test on a men’s panel, and why no marketed panel can be compared to it.