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GPs issue 10-day deadline on Viagra
The government fears an annual 1bn bill
GPs will start prescribing Viagra on the NHS - in contravention of a government ban - unless the Department of Health issues guidelines in the next 10 days.

Before Christmas the GPs committtee of the British Medical Association gave the government a month to issue the promised guidance on NHS prescribing of the anti-impotence drug.

It has now set a deadline of 21 January, when the committeee next meets, after which it will advise doctors to prescribe where they regard it as clinically necessary.

The Department of Health put a block on NHS prescription of the drug in September amid fears that excessive demand could cost the health service more than 1bn a year.


Currently, the tablets are available privately, costing 12 each. The price to the NHS is 4.86 a tablet.

Doctors were told they could only prescribe the drug on the NHS in "exceptional circumstances" until ministers issued further guidance.

Dr John Chisholm
Dr John Chisholm: "Governmental inconsistency"
However, the guidance was first expected out before Christmas and has so far failed to appear.

Some GPs are already ignoring the government ban and prescribing it where it is needed, the BMA has said.

Dr John Chisholm, chairman of the BMA's GP committee, said there was an inconsistency between the Department of Health's ban, and GPs' terms of service which placed an obligation on them to respond to patient's needs.

He denied GPs were issuing an ultimatum to the Department of Health.

He said: "This is a plea to the government to come off the fence.

"There is great concern out there among GPs, many of whom are already prescribing this drug on the NHS as time has drifted by."

Dr Ian Bogle
Dr Ian Bogle: "Doctors have been placed in an impossible position"
Before Christmas, Dr Ian Bogle, chairman of the BMA wrote to Health Secretary Frank Dobson.

He said: "Doctors have been placed in an impossible position: on the one hand they are mindful of the Department's request not to prescribe Viagra but on the other have to respond to the needs of their patients.

"Indeed, to refuse to prescribe this licensed medicine on a prescription form when it is clinically necessary would leave GPs open to accusations of breaching their terms of service."

'Virility rights'

The Chairman of the Patients' Association and former Agony Aunt Claire Rayner says people should not see the drug as a right.

She said: "What worries me is that people will think they have a God-given right to always be right at the top of the virility level.

"That is not realistic and that is the message I am trying to get across to people.

"Provide it for those whose need is deeply and undoubtedly medical/surgical - for the rest of us let's keep a bit of common sense about this."

'Chaotic situation'

Roger Kirby, consultant urologist at London's St George's Hospital, which sees 50 patients a month with erectile problems, describes the present situation as "chaos".

He said: "We have chaos right now, total chaos. Some GPs are regarding every patient as being exceptional and giving it [Viagra] to everyone.

"Some GPs are regarding the guidelines from the government that the drug is so-called blacklisted, so they are not giving it to anyone.

"We have a ridiculous paper chase over a drug which costs 4.86 a tablet."

Dr John Chisholm explains why the BMA has taken this step
The BBC's Health Correspondent James Westhead: "Increasing numbers of doctors are frustrated"
See also:

02 Jun 98 | Medical notes
25 Nov 98 | Viagra
12 Mar 99 | Viagra
13 Jan 99 | Viagra
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