End restrictions on prescribing Viagra, urges coalitionBMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7283.385 (Published 17 February 2001) Cite this as: BMJ 2001;322:385
A coalition of doctors and patients, involving the BMA, the Men's Health Forum, and the Doctor Patient Partnership, has called on the government to remove the restrictions placed on GPs who wish to prescribe sildenafil (Viagra) as a treatment for erectile dysfunction.
After the launch of sildenafil in the United Kingdom, the government, concerned that demand for the drug would lead to soaring costs, restricted its availability on the NHS to men with one of 12 specific underlying medical conditions (BMJ 1999;318:1305).
Men with cardiovascular disease, and those with impotence of psychological origin, are excluded from receiving the drug on the NHS. Men with “severe distress” must be referred to a hospital specialist—usually a urologist—to get an NHS prescription.
The Department of Health had promised to review these restrictions after a consultation period—which ended last week—and to give a decision within the next few months.
Dr John Chisholm, chairman of the BMA's General Practitioners Committee, said: “In dressing up a rationing decision as a clinical one, the government has ended up with the worst of all possible worlds: a decision that makes no sense on clinical, equity, or cost effectiveness grounds.” The level of demand for the drug, he said, has been “decidedly less than the exaggerated fears that were being talked about in 1999.”
The coalition believes that GPs are better placed than specialists to treat men with distress. Simon Fradd, chairman of the Doctor Patient Partnership, said: “The family doctor is uniquely placed to make a judgment about the effect that erectile dysfunction is having on the patient's life.”
While GPs are able to issue private prescriptions to any man with impotence, regardless of its cause, the coalition believes that this has created inequality in treating the condition. Dr Ian Banks, chairman of the Men's Health Forum, said: “Men with low incomes who don't qualify for NHS treatment are unlikely to be able to afford a private prescription.”
The forum is sponsored in part by Pfizer, manufacturers of sildenafil (BMJ 2000;320:598), but Dr Banks told the BMJ that this sponsorship was not being used to fund the current campaign.