people who say they're worse off on finasteride are usually those who go through the finasteride shed and dont recover from it. i guess if you've already thinned out quite a bit before you start propecia, and you go through a synchronous shed (even though you're supposed to lose the hair you shed on propecia anyway) but just the fact that you lose it in one go MIGHT have a cosmetic effect, and the people who dont really recover from it obviously will claim finasteride messed up things for them...
in my case i dont know if finasteride gave me some sort of Telogen Effluvium or not, but since nobody can explain i have my own theory that it DID, cause i lost alot of hair from the NAPE area from some strange reason as well as all over, and i had almost a full head of hair when i started, yet after the shed, its been 7 months of shedding so far and i havent seen thickening of any portion on my scalp. in fact, the back (nape) keeps getting worse, and so do my sideburns.
but i think i'm a freak case, i've posted here and on HLH repeatedly asking if anybody else has lost hair from these regions and theres always hardly 1 or 2 other people who know what i'm talking about.
the bottom line is, everyone is different, and you'll never know till you try. as for spending 60$ /month on finasteride, thats just plain foolheaded in my opinion. go for the generic. i get mine for 3 $ / month. have been having libido side and have gone through the shed so i know its the same. plus a few people who're using the same med i am called "HairFin" are having fantastic results.