Intended for healthcare professionals


Cost effectiveness of sildenafil calls for political discussion

BMJ 2000; 321 doi: (Published 19 August 2000) Cite this as: BMJ 2000;321:510
  1. Elly Stolk, research fellow (,
  2. Jan Busschbach, senior researcher
  1. Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands

    EDITOR—Freemantle comments on our analysis of the cost effectiveness of sildenafil. 1 2 He argues that the validity of quality adjusted life year (QALY) measures is based on strong assumptions and the measures are therefore insufficient for political decision making. Given that our analysis takes a conservative approach towards the cost effectiveness of sildenafil, however, these arguments cannot affect the conclusion that sildenafil is a highly cost effective drug.

    Freemantle recognises the assumptions of classical welfare theory on which QALY analyses can be based. This is not the only interpretation of QALYs. There is the extra-welfarist …

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