Interesting front page article in today's Independent (6.9.98):


"Doctors will not be allowed to prescribe Viagra, the "wonderdrug"
 hailed as a cure for impotence, on the NHS. Ministers fear that the
 cost of meeting potential demand would spiral out of control."

However, ministers do want some patients to be able to obtain
treatment - "the deserving impotent" - but only those with a genuine
medical problem. The article goes on to say that treatment will be
rationed and strict criteria will be drawn up to decide who is
eligible to receive it. Guidelines would be similar to those used for
allocating fertility treatment.

"The ban will be a "holding position" (shurely no pun intended?!)
 while the department considers its longer-term view."

"It is also likely that GPs will eventually be given the power to
 prescribe the drug to "suitable" patients, to avoid hospital
 consultants being overwhelmed."


Comment:

It seems the Department is still uncertain how to handle this issue.
Perhaps the outcome will be something like this:

1.  NHS treatment only prescribable by consultant. (though clearly we
    musn't overwork the poor darlings, must we? Let the GPs do the
    work - they'll have loads of free time once they stop dishing out
    antibiotics!)

2.  Strict nationally defined referral criteria - (unlike the
    infertility treatment criteria, which are a dog's breakfast. If
    we grasp the nettle for Viagra, perhaps the NICE could draw up
    some national guidelines for other areas too: e.g. infertility,
    beta-interferon, donezepil)

3.  GPs able to issue private prescriptions only. (workload
    implications not thought through: it may only amount to three or
    four consultations a week, but that racks up demand by another
    couple of percent. Like managing hyperlipidaemia, anti-clog
    control, 2nd line rheum. drugs and other "innovations" which have
    crept in over the past five years - all resulting in a small but
    cumulative increase in workload).


Interesting times!


Trims.


-- 
Dr Ian Trimble                        http://www.sherwood.demon.co.uk/
Sherwood Health Centre              
Elmswood Gardens                                 Tel: +44 115 962 4516
Nottingham     NG5 4AD                           Fax: +44 115 985 7899



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