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GPs slam secrecy over evidence for Viagra restrictions

GPs have criticised a controversial decision by managers not to publish the evidence base for restricting erectile dysfunction drugs to two pills a month.

Earlier this month, Pulse revealed that GPs in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire were being advised to apply a twice-a-month limit to prescriptions for sildenafil (Viagra), varednafil and tadalifil, as opposed to the usual prescription of four a month.

Prescribing of medication for erectile dysfunction on the NHS is already subject to severe restrictions, with availability limited to patients with specific conditions including diabetes, multiple sclerosis and prostate cancer. PCTs insisted the new policy was ‘a recommendation to GPs', but LMC leaders raised concerns it was being presented to GPs as ‘edicts'.

The recommendation from the South Central Priorities Committee's MOBBB (Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire) PCTs group was based on a study by Solutions for Public Health, a not-for-profit NHS organisation. The copyrighted study is not available to the public, a situation described as ‘counterproductive' by GP leaders.

In an email to MOBBB and LMC representatives, Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxon LMCs, said: ‘This seems a counterproductive protection of intellectual property that harms the credibility of MOBBB and SPH.'

‘The consequence of this failure to be open is that the rest of the clinical world and the public cannot see how the decision was arrived at, and suspicion escalates.'

However, the SPH insists the evidence reviews are ‘freely available within all the PCTs that commission our service' and a spokesperson from Oxfordshire PCT said they were contractually obliged to restrict access to the document.

She said: ‘As far as we're concerned we're not allowed to, because of the contract we hold with them, publish the evidence they give us because it's their product, it's what they produce, it's not our intellectual property, it's not something we produce.'

‘We can share it among the PCTs, we can share it with staff but we aren't able to publish it on a public website for example.'

Speaking to Pulse, Dr Paul Roblin, chief executive of BBO LMC, said GPs and senior members of the PCT were against the decision not to publish the evidence review.

Dr Roblin added: ‘There are four organisations involved: the PCT clusters, the MOBBB committee itself, and the SPH, we're trying to find who actually supports the restriction of information, it's actually quite difficult, they all blame each other'.

‘Nobody makes a moral or ethical comment as to whether it is right to restrict the information.'

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