Exclusive GPs have been urged to shift men with erectile dysfunction to sildenafil (Viagra) in order to reap the benefits of an expected price reduction of around 96% as generic versions of sildenafil start to flood the market from this week.
Pulse has learnt that CCGs anxious to capitalise on the expected price reduction to around £1 per tablet have already recommended GPs shift patients to sildenafil and away from other drugs.
Pfizer’s patent on Viagra expired at midnight last Friday and the pharmaceutical giant is among a number of companies, also including Teva and Actavis, already launching generic versions of the drug.
A pack of four tablets of any strength is now available for £1 to £2 to pharmacies, compared with the listed price to the NHS of between £16.59 and £23.50 for a four-tablet pack of branded Viagra.
NHS drug tariffs could take some months to stabilise, but Teva is currently charging just £1.28 for a pack of 50 mg sildenafil tablets, while Actavis is charging £1.49.
Dr David Russell, prescribing lead at Darlington CCG and a GP in the town, said his own CCG has already been recommending practices switch to prescribing sildenafil.
He said: ‘On financial grounds there will be a compelling argument to prescribe sildenafil first line now and in fact we, and I suspect many other CCGs, have been promoting sildenafil first line for several months previously in recognition of the fact that it was due to come off-patent.
‘We have also been looking at patients who have tried the alternatives but never sildenafil and will suggest that perhaps they should. For the considerable number of patients currently paying for these medications privately, this will help immensely.’
Dr Russell said it was not clear if more of these patients paying privately might now be able access treatment for erectile dysfunction on the NHS.
He said: ‘I’m not sure if that will change now. There will certainly be less of a “should I, shouldn’t I prescribe it on the NHS” decision-making process with such low prices.’
Dr Richard West, chair of the Dispensing Doctors Association and a GP in Bury St Edmunds, told Pulse that around 40% of patients currently prescribed Viagra are paying for it privately and that as the price for private prescriptions should also become more competitive, that proportion could increase.
He said: ‘It won’t change prescribing practice particularly, in that we should only be prescribing it to those who need it anyway. What it might lead to is more patients who fall outside the NHS-prescribing categories realising they can now afford it.’