ED Medication Cost Per Dose

Why cost per dose is not cost per tablet

There is no authoritative retail price for an ED tablet. What there is, and what almost nobody uses, is the National Average Drug Acquisition Cost: a monthly survey of the invoice prices retail community pharmacies actually pay, published weekly by CMS for every national drug code. It is a floor rather than a quote — it contains no dispensing fee, no markup, no telehealth consultation and no shipping, and nobody reading this can buy at it. Every figure on this page comes from one named file, the 16 September 2026 release, and the page says so next to each of them.

Read that file and the first surprise is how little the per-tablet rate moves with strength. Generic sildenafil is $0.12196 at 25 mg, $0.10577 at 50 mg and $0.12762 at 100 mg. The middle strength — the label's own starting dose — is the cheapest tablet of the three. Generic tadalafil is $0.10216 at 5 mg and $0.15815 at 20 mg, four times the drug for a third more money. Per milligram, those same rows fall by a factor of four. Per milligram is therefore the wrong unit for anything a reader can act on, because the milligrams are not sold separately.

That is where splitting would ordinarily come in, and it is where this page parts company with every other one. The tadalafil label does not merely omit permission to split; it opens its Dosage and Administration section, in bold, before naming any dose, with "Do not split CIALIS tablets; entire dose should be taken." The generic labels repeat it word for word with the brand name swapped: "Do not split tadalafil tablets; entire dose should be taken." The sildenafil, vardenafil and avanafil labels say nothing about splitting either way — and silence is not permission. Every Structured Product Label read for this page, brand and generic, declares the FDA Score characteristic as one piece, meaning no score line. FDA tells patients where permission would appear if it existed: "If a tablet is FDA-approved to be split, this information will be printed in the “HOW SUPPLIED” section of the professional label insert and in the patient package insert. Also, the tablet will be scored with a mark indicating where to split it." None of the four carries it. And where it is absent, "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." So no figure here is ever half of another figure.

The consequence is a gap this page prints rather than fills. Avanafil's labelled starting dose is 100 mg. The 16 September 2026 file prices one avanafil presentation, the 200 mg tablet, at $49.48. There is no 100 mg avanafil rate to quote and no lawful way to make one out of the 200 mg, so the cost of a labelled starting dose of avanafil is not stated on this page. Across everything that can be priced, one dose ranges from $0.10577 to $49.48 — 468× — for four drugs that the labels treat as alternatives to one another.

The last thing per-dose changes is tadalafil, which is the only one of the four with a licensed once-daily regimen. Twenty milligrams taken a few times a month and 5 mg taken every day are not two prices for one thing; they are two different products of price and frequency. At the acquisition rate, 5 mg daily runs $3.11 a month and $37.29 a year, flat. The 20 mg as-needed line crosses it at about 20 doses a month. That crossing point is the only number on this page CMS did not publish, and it is arithmetic rather than a recommendation — which regimen suits a man is a clinical question with two separate labelled dose ladders behind it.

ED medication cost per dose — every labelled dose

One swallowed dose at the NADAC acquisition rate in the 16 September 2026 file, built from whole tablets only. Find your drug and your dose; the last column is a year at 8 doses a month.

This is what a retail pharmacy paid for the drug, not what anyone is charged: no dispensing fee, no markup, no consultation, no shipping. Two rows say "Not priced" rather than guessing. Avanafil's labelled starting dose is 100 mg and the only avanafil presentation in the file is the 200 mg tablet, so the starting dose cannot be costed from it — and it cannot be reached by halving the 200 mg, because that label declares no score and FDA has not evaluated its halves. Notice that sildenafil's 50 mg starting dose at $0.10577 is cheaper per dose than its 25 mg at $0.12196, and that the whole column spans 468×.

Cost per tablet against cost per milligram

The same generic tablets read two ways. The per-tablet column is nearly flat within a drug; the per-milligram column falls by a factor of four across the same three rows.

Per milligram is arithmetic, not a price, and it is the number to be most careful with: it only means something if you can buy the milligrams separately, and on these four labels you cannot. The modal rate is the one the most NDCs in a description share — generic tadalafil 20 mg is the only group in this snapshot that is not unanimous, with 39 NDCs split between two rates. "Priced in the file" is how many NDCs CMS surveyed, which is a rough guide to how competitive a strength is.

Tadalafil daily against tadalafil as needed

Tadalafil is the only one of the four with a licensed once-daily regimen, so it is the only one where cost per dose has to be multiplied by a frequency before it means anything. Read down for how often you would take an as-needed dose.

The daily column is flat by construction — it is $0.10216 a tablet every day of the month, $37.29 a year. The as-needed columns slope. They cross at about 20 as-needed doses a month, which is the only figure on this page that is not in the CMS file. It is arithmetic on an acquisition cost and nothing else: the choice between the two regimens is clinical, the two have separate labelled dose ladders (2.5 mg then 5 mg daily, against 5 mg to 20 mg as needed), and neither label mentions price. The table stops at 30 because all four labels cap dosing at once per day.

Brand against generic, same strength, same file

Every brand row NADAC prices, paired with the generic tablet of the same drug and strength. The multiple is the brand rate divided by the generic rate.

CMS prints its own figure for the corresponding generic on each of these brand rows, and it matches the generic rate transcribed independently here to five decimal places on all four — which is the best check available that this snapshot was read correctly. The VIAGRA 100 MG TABLET multiple of 655× is between two products containing the same milligrams of the same molecule. There is no LEVITRA row and no STENDRA row in the file at all.

Figures this tool will not give you

Printed here rather than omitted, because a number that is missing and a number that was never obtainable look identical on a page.

3 of the 18 ED description groups in the 16 September 2026 file are priced and then not used by this tool, each for a stated reason. Silently dropping them would have made the page look more complete and been less true.

Frequently asked questions

How much does one Viagra pill actually cost?

In the 16 September 2026 CMS acquisition file, a retail pharmacy paid $83.63 for one brand VIAGRA 100 mg tablet and $0.12762 for one generic sildenafil 100 mg tablet — a multiple of 655× for the same milligrams of the same molecule. Neither is what you are charged. NADAC is the invoice price before any dispensing fee, markup, rebate, consultation fee or shipping, and this page will not guess what sits on top of it, because no public dataset records that.

Can I split a tadalafil or sildenafil tablet to halve the cost?

Not on any label read for this page. The tadalafil label is explicit and puts it first: "Do not split CIALIS tablets; entire dose should be taken." — the same sentence appears in section 2 of six generic tadalafil labels and on the cartons. The sildenafil, vardenafil and avanafil labels say nothing about splitting at all, and every Structured Product Label checked declares the FDA Score characteristic as one piece, which means no score line. FDA's position on tablets like those is that "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." So this page contains no split-tablet arithmetic, and any saving that depends on halving a tablet is not a saving it will compute.

Is the cheap 20 mg sildenafil tablet a way to get 100 mg for less?

Not at the acquisition price, which is the opposite of what people expect. The 20 mg sildenafil tablet is the pulmonary arterial hypertension product, and NADAC prices it at $0.05101 — less than half the 100 mg tablet. But five of them cost $0.25505 against $0.12762 for one 100 mg tablet, which is 2.0× the price for the same milligrams. It is also not an ED strength: it is absent from the VIAGRA label's Dosage Forms and Strengths section, and that label tells patients "not to take VIAGRA with other PDE5 inhibitors including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil". This tool excludes it and says so.

Is daily tadalafil cheaper than taking it as needed?

It depends entirely on how often, and the crossover is computable. At the 16 September 2026 acquisition rate, tadalafil 5 mg once daily costs $3.11 a month — $37.29 a year — and does not change with frequency. Tadalafil 20 mg as needed costs $0.15815 a dose, so the two lines cross at about 20 as-needed doses a month. Below that, as-needed is cheaper on drug alone; above it, daily is. That is arithmetic on a floor price, not advice: the two are separate labelled regimens with separate dose ladders, and the label mentions cost nowhere.

Why does this page refuse to give a cost for a 100 mg avanafil dose?

Because there is no honest way to produce one. Avanafil's labelled starting dose is 100 mg, and the 16 September 2026 NADAC file prices exactly one avanafil presentation — the 200 mg tablet, at $49.48. Halving that tablet would give a plausible-looking $24.74, and it would be a fabrication: the avanafil label declares no score, says nothing about splitting, and FDA has not evaluated whether two halves carry the same drug content. A missing number that is labelled as missing is better work than a confident wrong one.

Why is vardenafil 5 mg more expensive than vardenafil 20 mg?

It is, and the file says so plainly: the 5 mg tablet is $7.10 against $2.97 for the 20 mg, which is 2.4× the price for a quarter of the drug. That matters clinically as well as financially, because 5 mg is the starting dose the label gives a man already stable on an alpha-blocker. The 5 mg row also carries NADAC explanation code 4 — "The NADAC was carried forward from the previous file" — with an effective date of 18 March 2026, so it has not been resurveyed since March, while the 20 mg row was resurveyed in August. A carried-forward rate is a stale rate, and the page prints the code rather than hiding it.

Are the two vardenafil 10 mg products the same price?

No, and the label says they are not the same product. NADAC prices the 10 mg film-coated tablet at $1.91 and the 10 mg orally disintegrating tablet at $24.87 — 13.0× the price for the same nominal strength. The orally disintegrating label states: "Vardenafil hydrochloride orally disintegrating tablets are not interchangeable with vardenafil 10 mg film-coated tablets (LEVITRA). Vardenafil hydrochloride orally disintegrating tablets provide higher systemic exposure compared to vardenafil 10 mg film-coated tablets (LEVITRA)". This tool prices only the film-coated tablet, which is the form the rest of this site quotes, and names the other in its exclusions table.

What is NADAC, and why use it instead of a coupon price?

NADAC is the National Average Drug Acquisition Cost: CMS surveys retail community pharmacies monthly on what they actually paid on invoice, and republishes the result weekly per national drug code with a methodology document behind it. A coupon price is a marketing number with no methodology, no schedule and usually no date. NADAC is not a price you can pay — it is a published floor below which the drug does not exist commercially, and the distance between it and what you are quoted is the whole of the dispensing, distribution and telehealth economics. Because the file is republished weekly, every figure here names the 16 September 2026 release rather than claiming a permanent price.

Sources

1. [1]CMS Medicaid — National Average Drug Acquisition Cost (NADAC) dataset landing page, with the methodology and data-field definitions for NADAC Per Unit, Pricing Unit, Classification for Rate Setting and the explanation codes
2. [2]CMS Medicaid — the NADAC weekly file of 16 September 2026, from which every rate on this page was transcribed. Filtered to rows whose As of Date is 09/16/2026 and whose NDC Description names sildenafil, tadalafil, vardenafil, avanafil, VIAGRA, CIALIS, LEVITRA or STENDRA: 258 rows in 18 description groups, no LEVITRA row and no STENDRA row
3. [3]DailyMed — CIALIS (tadalafil) tablet, film coated, Eli Lilly and Company. Section 2 Dosage and Administration opens: "Do not split CIALIS tablets; entire dose should be taken." The cartons in section 16 read "Tablets should not be split. Entire dose should be taken." Product Characteristics declare Score: 1
4. [4]DailyMed — TADALAFIL tablet, Ajanta Pharma USA Inc. Section 2 Dosage and Administration opens: "Do not split Tadalafil tablets; entire dose should be taken." The same sentence opens section 2 of the Teva, Accord, Torrent, Solco and Alembic generic tadalafil labels
5. [5]FDA — Tablet Splitting: "If a tablet is FDA-approved to be split, this information will be printed in the “HOW SUPPLIED” section of the professional label insert and in the patient package insert. Also, the tablet will be scored with a mark indicating where to split it." and "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."
6. [6]DailyMed — VIAGRA (sildenafil citrate) tablet, film coated, Pfizer Laboratories Div Pfizer Inc. Section 3 lists "Tablets: 25 mg, 50 mg, 100 mg" — there is no 20 mg ED strength — and section 17 advises patients "not to take VIAGRA with other PDE5 inhibitors including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil". Product Characteristics declare Score: 1
7. [7]DailyMed — VARDENAFIL tablet, orally disintegrating, Alembic Pharmaceuticals Inc. (NDC 62332-235-04, one of the two ODT codes NADAC prices). Section 2.1: "Vardenafil hydrochloride orally disintegrating tablets are not interchangeable with vardenafil 10 mg film-coated tablets (LEVITRA). Vardenafil hydrochloride orally disintegrating tablets provide higher systemic exposure compared to vardenafil 10 mg film-coated tablets (LEVITRA)"
8. [8]DailyMed — STENDRA (avanafil) tablet, Metuchen Pharmaceuticals, LLC. Section 2.1: "The recommended starting dose is 100 mg." Section 3 lists "Tablets: 50 mg, 100 mg, 200 mg"; NADAC prices only the 200 mg. Product Characteristics declare Score: 1
9. [9]DailyMed — VARDENAFIL tablet, film coated, Zydus Pharmaceuticals USA Inc., the current-format vardenafil label this site quotes throughout. Section 2.1: "For most patients, the recommended starting dose of vardenafil is 10 mg, taken orally, as needed, approximately 60 minutes before sexual activity."