Serving the people of north east Essex Prescribing Of Drugs For Erectile Dysfunction (ED)
The prescribing of drugs for ED on FP10 was formerly covered by Schedule 11 and has since been enshrined in Part 3 para. 42(2) of the National Health Service (GMS Contracts) Regulations 2004. This laid down clear criteria for prescribing, in that treatment on the NHS should only be made in men who:
Have diabetes, multiple sclerosis, Parkinson’s disease, poliomyelitis, prostate cancer, severe pelvic injury, single gene neurological disease, spina bifida or spinal cord injury.
Are receiving dialysis for renal failure.
Have had radical pelvic surgery, prostatectomy or kidney transplant.
Were receiving Caverject, Erecnos, MUSE, Viagra or viridal for ED, at the expense of the NHS, on 14 September 1998.
Are suffering severe distress as a result of impotence – prescribed in specialist centres on FP10HP and NOT by GPs on FP10
Health Service Circular 1999/177. Treatment for impotence, patients with severe distress. The prescription must be endorsed ‘SLS’ in al of the above. The above are the ONLY conditions in which prescribing is permitted under the NHS. NOT more than four doses per month should be prescribed. (Health Service Circular 1999/148. Treatment of impotence.) Examples of conditions involved in recent prescribing include various prostate problems and hypertension (non-diabetic). Prescribing on a private prescription is permitted for these drugs in such situations even if the patient is receiving other NHS treatment. Prescribing for conditions outside the Regulations may render the prescriber liable for payment for the drugs. Drugs included:
Alprostadil - Caverject®, Viridal Duo®, MUSE®
Sildenafil should be considered first line as first line treatment. It is not only currently cheaper than tadalafil and vardenafil but the patent will expire in June 2013
Cialis 10mg and 20mg are approved for prescribing locally but the 2.5mg and 5mg products intended for daily use are not (approximately twice the price).
This policy is updated subsequent to December NEEMMC.
Specialist centres would normally be those addressing mental health problems such as the mental health trust. Comments from clinical cabinet are welcomed on availability of such services
It is probable that post-radical prostatectomy a policy on penile rehabilitation will be developed but this will not be provided through GPs.
Pumps for erectile dysfunction can be prescribed on FP10
APPROVED BY: North East Essex Medicines Management Committee January 2010
REVIEW DATE: January 2012 AUTHOR: Mary Tompkins, Assistant Director (Evidence Based Medicine & Medicines Strategy (NHS NE Essex)
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