A retrospective, study of prescribing for erectile dysfunction in a UK population during 1997-2000: demand was neither excessive nor continuing to rise.

Abstract

The UK NHS restricted the prescription of sildenafil to a range of clearly defined clinical situations. We describe the pattern of pharmaceutical management of erectile dysfunction (ED) during the period when the new drug was introduced and then regulated. We studied the population of males aged over 16 (n = 121,783) who were continuously registered with 60 practices in Tayside between 1 October 1997 and 30 June 2000 using record linkage and case-note verification. The patients' GPs allowed a research nurse to examine the records of these patients for demographic details, comorbidities and resource use. Five hundred and fifty five patients received 2493 prescriptions for alprostadil or sildenafil. The addition of an oral agent to the available therapies in 1998 did lead to a more rapid rise in prescribed treatments but this reached a plateau 3.47 per 1000 adult males per quarter after 12-15 months. Fifty eight per cent of the men had a comorbidity associated with ED. More comorbidities were found in men aged 50-69 and those living in areas of greater deprivation. Depression was a more common comorbidity in younger patients and more men from affluent areas were prescribed sildenafil following prostatectomy. In the Tayside region of the UK, the introduction of an effective, acceptable oral therapy for erectile dysfunction led to a rise in prescriptions issued for ED. This rise appeared to stop after 12-15 months, perhaps partly because of the governmental restrictions imposed.