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Tuesday, July 7, 1998 Published at 15:54 GMT 16:54 UK


Viagra 'could overwhelm the NHS'

Viagra could cost the NHS 1bn, warn doctors


The BBC's Fergus Walsh on Viagra
Massive demand for the impotence wonder drug Viagra could overwhelm NHS services and cost at least 1bn a year, doctors have warned.

The drug, set for launch in the UK in September, could benefit around 10% of the male population believed to suffer from impotence, but doctors also fear it will be abused by healthy men seeking to boost their sexual performance.

Tests indicate the drug could also benefit women.

Public health minister Tessa Jowell has confirmed that Viagra will be available on the NHS for those who clinically need it.

But doctors at the annual British Medical Association conference in Cardiff said new resources would have to be made available to avert a crisis in the NHS.

Derek Machin, a urologist from Liverpool, estimated that Viagra could double the number of patients who attended his out-patient clinics at a stroke.


No test available

He warned that, as there was no readily available clinical test for impotence, the potential for abuse was a serious concern.

"Thus far we have had no reason to doubt the veracity of patients complaining of impotence," he said.

"But we are now faced with an entirely new situation. For the first time we are faced with an effective oral preparation perceived as improving performance of the already potent. It could be a major drug of abuse."

Mr Machin said costs of the drug, assuming patients required two tablets costing up to 8 each a week, could top 1bn - one quarter of the entire NHS drugs budget.

"I welcome the drug Viagra . It is a splendid new drug that is going to change the quality of life for very large numbers of people," he said.

"But the problem we are going to have if the government decides to push prescribing of the drug into secondary care is that this is going to completely overwhelm urology services."


[ image: Dr Peter Holden warns of 'sex by postcode']
Dr Peter Holden warns of 'sex by postcode'
Dr Peter Holden, a GP from Derbyshire, said that unless new resources were made available for Viagra the public faced "sex by postcode" with many areas unable to finance the drug.

Dr Holden said approximately 250 men at his practice alone could probably benefit from the drug - pushing up his drugs bill by 125,000 a year.

However, Belfast GP Dr Ian Banks warned that the medical profession had a duty to be positive about Viagra, whatever the cost of the drug.

Terrible blight

He said impotence was a terrible blight which led to depression, alcoholism, marital breakdown and even suicide, not only among sufferers, but also among their families.

"To simply say this is an expensive drug and we have to curtail its use is flying in the face of what all our training as medical practitioners has been about," he said.

"We should be saying this is a serious medical condition that affects a large number of people, and we should be saying we welcome anything that could improve the lot of these people and we will prescribe this medicine on the basis of clinical need, not on the basis of resource management."

The conference called on the government to launch an urgent review of the way new expensive drugs are licenced for use in the UK.

Easy to spot fakers

A spokesman for Viagra manufacturer Pfizer said: "Anyone can speculate on the number of men who may present themselves to clinics. There are guidelines in development which take into account all of those things to ensure that GPs are armed with the information they need to make a proper diagnosis.

"Men who want the drug simply to pep up their sex life can be easily spotted and, if they are foolhardy enough to attempt this, GPs will be in a position to recognise them for what they are and not to burden the taxpayer with a prescription."

Viagra works by relaxing the tissue around the penis, so that blood can flow more easily to the area. At least 24 men have died in the US after ignoring warnings that the drug should not be taken in combination with medication for certain heart conditions.



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