BMJ 2000;320:1156-1157 ( 29 April )

Editorials

Valuing the effects of sildenafil in erectile dysfunction

Strong assumptions are required to generate a QALY value

Papers p   1165

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

Sildenafil is a true breakthrough drug in the sense that it provides a potential treatment for a condition for which there was no existing acceptable alternative. This complicates any attempt to describe the cost effectiveness of sildenafil in erectile dysfunction, such as that by Stolk et al in this week's BMJ (p 1165).1 They compare sildenafil with papaverine-phentolamine injections, which they argue are rationed on "medical grounds" and will not achieve the population benefits that might be achieved by sildenafil. More controversially, they argue that "the incremental cost-effectiveness of sildenafil lies at the favourable end of the scale when compared with interventions in health care for other diseases."

The comparator therapy Stolk et al refer to, papaverine-phentolamine injections, seems not to have been rigorously evaluated and is not widely used. They used a cost utility approach in which a representative sample of the general population were asked to value . . . [Full text of this article]
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Relevant Articles

Cost effectiveness of sildenafil calls for political discussion
Elly Stolk and Jan Busschbach
BMJ 2000 321: 510. [Extract] [Full Text] [PDF]

Cost utility analysis of sildenafil compared with papaverine-phentolamine injections
Elly A Stolk, Jan J V Busschbach, Max Caffa, Eric J H Meuleman, and Frans F H Rutten
BMJ 2000 320: 1165. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

  • Gilbert, D., Walley, T., New, B. (2000). Lifestyle medicines. BMJ 321: 1341-1344 [Full text]  
  • Stolk, E., Busschbach, J. (2000). Cost effectiveness of sildenafil calls for political discussion. BMJ 321: 510-510 [Full text]  

Rapid Responses:

Read all Rapid Responses

THE OBVIOUS COST-EFFECTIVENESS OF SILDENAFIL CALLS FOR A POLITICAL DISCUSSION, NOT A TECHNICAL ONE
Elly Stolk, et al.
bmj.com, 4 May 2000 [Full text]
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