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Viagra prescribing restrictions scrapped

GPs can now prescribe generic Viagra to any man with erectile dysfunction, after the Department of Health finally scrapped unpopular prescribing restrictions.

The reversal, which a GP leader has said addresses “an historic injustice”, will now see the NHS fund all prescriptions for generic sildenafil, regardless of clinical circumstances.

Previously, the drug was restricted to men with conditions such as multiple sclerosis, diabetes and prostate cancer, due to fears of a cost blowout.

However the expiry of Viagra’s patent in June 2013 led to the drug’s cost to the NHS to plummet by 93%, from £21.27 to £1.45 for a four-tablet pack, prompting the Department of Health to lift the restrictions, which had stood since 1999.

The changes apply only to generic sildenafil and apomorphine hydrochloride – the DH decided against lifting restrictions on branded Viagra and other ED therapies such as tadalafil, alprostadil and avanafil.

Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee, welcomed the move, saying it “partially corrects an historic injustice done to men, and their partners, who were denied an effective treatment for a distressing condition”.

“Erectile dysfunction remains the only condition to my knowledge where the entitlement to NHS care is dependent not on the condition itself but on its aetiology. It remains unjustifiable that men with impotence due to medication side-effects, for example, are denied treatment in contrast to those who have the same problem but due to surgery,” he said.

Surrey GP and clinical adviser to RCGP on prescribing, Dr Martin Duerden said the previous restrictions had ‘denied many patients with genuine need access to an effective intervention’.

He said: ‘Patients getting private prescriptions for these drugs should now be offered the opportunity of changing to generic sildenafil on NHS script, if they wish. However they may still prefer paying for the brand product if they find this works better for them.’

The change to the legislation follows a consultation earlier this year by the DH. It received 87 responses, 81% of which supported the proposal to widen access to generic sildenafil.

By boosting access through the NHS, the changes could also help stem the trade in counterfeit and unlicensed Viagra from unregulated online pharmacies, a DH consultation paper states. However some submissions felt the move could have the opposite effect, leading patients to on-sell their drugs via the black market.

NHS England will now consider whether to issue further guidance about appropriate prescribing.

The changes are likely to have a significant impact on GPs’ workload: an earlier impact assessment predicted demand for sildenafil could as much as treble once the restrictions were lifted.

Readers' comments (11)

  • Vinci Ho

    Only a matter of time for this to happen.
    Welcome but cautiously as you need more GPs to provide the consultations . Men are tended to see male GPs for ED treatment although the problem could have been identified first by practice nurses on diabetic review , for instance.
    Also , the low dose PD5 inhibitor on daily basis e.g. 50mg Sildenafil od may be an option to try in resistant cases, though not licensed( in contrast to tadalafil 5mg od) .

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  • I think it's illegal - indirect discrimination based on sex. Afterall HRT isn't resticted. Breast symptoms are gauranteed 2 week OPD appointment even if benign.

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  • John Glasspool

    Some of us ignored the restrictions anyway, I am sure.

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  • Welcome news to all those who has suffered due to those unjust guidelines. This will usher in a new era of productive young men who will go into the workplace with their heads held high. It will give us happier women working at the checkouts and they will smile at you, asking how your day was and give you a hand packing the items you have purchased. Oh Great Britain, we salute you for this wonderful ruling and we salute the DOH for making this happen.

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  • Anonymous 17 August 2014 2:47am

    A very funny comment.

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  • just more burden on proimary care consultations/access and the prescribing budget. Until co-payment or insurance-based primary care exists, we should not be adding to the list of prescribable medicines.

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  • Obviously this has come about due to the expiry of this patent. Obviously there is stiff competition from similar drugs and other manufacturers (some of the have been a flop in comparison) but it's correct for this fine and upstanding government to take this decision.

    Hopefully the generic is as potent as the branded version and this doesn't climax in terms of people asking for the Pfizer version.

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  • congratulations to Anonymous | Sessional/Locum GP | 18 August 2014 11:28am - just as we would all have liked to say. Assume same will apply to Levitra whose patent must end soon?

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  • All this does politically is to announce that the government rationed an effective treatment (or the average age of the DH civil servant has risen).

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  • Should have been OTC from the start.

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