Viagra: a botched test case for rationing

BMJ 1999;318:273-274 ( 30 January )

Editorials

Viagra: a botched test case for rationing

If it leads to a proper debate about rationing the decision on sildenafil will not be entirely bad

News p 279 Reviews p 338

The first 150 words of the full text of this article appear below.

The recent decision of the secretary of state concerning how sildenafil (Viagra) will be made available within the NationalHealth Service¹ will have angered most men with erectile dysfunctionand has caused grave disquiet among doctors.² In dressing upa rationing decision as a clinical one, the secretary of statehas ended up with the worst of all possible worlds: a decisionthat makes no sense on clinical, equity, or cost effectivenessgrounds and has alienated communities that need to be engagedif rationing is to beacceptable.

Sildenafil was licensed for use in the United Kingdom on 15 September 1998. The previous day the NHS Executive issued guidanceabout the drug, stating that ministers would be considering theevidence and drawing up substantive policy proposals within thenext few weeks; as an interim measure, the Standing Medical AdvisoryCommittee had advised that doctors should not prescribe sildenafil.³At that time most . . . [Full text of this article]

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