Give impotent men Viagra

Only men with impotence from certain conditions can have Viagra

Eighty-one per cent of the UK population think men with impotence should get treatment on the NHS, a survey has found.

The MORI poll was commissioned by the Impotence Association. It also found 85% thought it should be up to a doctor to decide who gets the treatment on the NHS. 

There has been widespread condemnation of the government's stance on Viagra. The Department of Health said it received about 800 submissions as part of its consultation on the interim prescribing guidance.
The consultation closed on Thursday and the department will now consider the submissions before producing final guidelines. 

A spokeswoman said doctors, patients, patient groups and medical bodies had all contributed.
Many of these groups were critical of the interim guidance and made their evidence public. 

Restrictions
On 21 January, Health Secretary Frank Dobson issued interim guidelines on the prescription of Viagra.
Under the guidance, Viagra is available on the NHS to to men with conditions such as multiple sclerosis, diabetes and spinal injury.
However, he denied the treatment to men whose impotence was caused by psychological factors. 

He then said there should be a consultation period and invited comments from all interested parties on how Viagra. 

Viagra has caused particular interest because it is the first time a Health Secretary has intervened to ration NHS treatment. 

'Against the principles of the NHS'
The Impotence Association is submitting a statement signed by itself and other groups. 

It said: "The proposal issued by the Department of Health on January 21 regarding prescription of treatments for erectile dysfunction (impotence) on the NHS is discriminatory and unacceptable.
"It contradicts the founding principle of the NHS, which advocates treatment for all patients with a clinical need."

Frank Dobson imposed the restrictions

It adds that the current guidance means only 15% of men with erectile dysfunction will get the drug. 

"Impotence affects people in the same way, no matter what the cause," it said.
Mr John Pryor, is chairman of the association and a consultant urologist.
He said: "Discrimination is unacceptable and we must insist that newly diagnosed sufferers and their partners receive the treatment they deserve on the NHS and the right of those already receiving treatment is safeguarded."
Pfizer, the drug's manufacturer, supported this position.
In its evidence, it says the guidance divides sufferers into worthy and unworthy patients. 

It adds that it contradicts the government's policy that treatment should be available on the basis of clinical need alone. 

'Evidence should support rationing criteria'
Doctors also condemned the current restrictions.
The British Medical Association's GP Committee said the guidance ignored clinical evidence.
The eligible categories of patients have been selected without regard to evidence of cost effectiveness, equity, or social values, it adds. 

Dr John Chisholm protested at how the criteria were set

Dr John Chisholm, chairman of the GPC, has written to the Health Secretary.
He said: "Our main concern is that, for possibly the first time within the NHS, national policy will determine that patients with equal clinical need are to be treated differently." 

He said that in future rationing decisions would have to be made more carefully.
Dr Ian Banks is chairman of the Men's Health Forum and a spokesman for the BMA.
He said: "The Government has an unwarranted concern that men with normal sexual function will seek to enhance their potency, with the availability of new, more effective and convenient management options. 

"Yet, GPs are perfectly capable of diagnosing those patients who are genuinely suffering from impotence." 

Difficulty setting priorities
John Appleby is health systems manager of the King's Fund, an independent health care watchdog. 

He said the government's restrictions may not be fair.
"There is no reason why men with conditions like multiple sclerosis, diabetes and spinal injuries are any more 'deserving' of the drug than those who suffer from impotence for other reasons," he said.
He added that the government should aim to make rationing fairer and more transparent.
The National Institute of Clinical Excellence, which comes into being on 1 April, could be responsible for developing a rationing framework, he said. 

The fund welcomed the recognition that some treatments should be the subject of a national debate, but was concerned the government might dump difficult decisions on NICE. 

Political decisions
Steve Dewar, King's Fund fellow in effective practice, said: "It is the job of a political leader, not a civil servant, a committee or a doctor, to make tough choices about the allocation of public money for public good.
"Politicians have for some time dodged the rationing issue by using labels like 'priority-setting' or by leaving tough choices to doctors and health authorities. 

"The Government should not leave NICE to advise the NHS on the cost effectiveness of new drugs without public involvement or political debate." 

The Department of Health will make a statement on Thursday, a spokeswoman said.
It will outline how much evidence has been presented to the government on the issue.
The government will then consider the submissions.

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Health warnings to Viagra users

Reports of deaths and side-effects have prompted warning labels

New warnings about the risks in using the anti-impotence drug, Viagra, are being issued in the United States.

The Food and Drug Administration (FDA) says it agreed with the manufacturer, Pfizer, on extra wording on the drug's label, after reports of deaths and severe side-effects among Viagra users.
While stressing that it still believes Viagra is safe, the FDA says the new warnings make clear that patients with a history of particular health problems should be carefully examined by a doctor before they are prescribed the drug.
Since Viagra went on the market in April, 69 men have been reported to have died after taking it.
"The revised labelling addresses post-marketing reports of heart attacks, sudden cardiac deaths and hypertension," the FDA said in a statement.

History of heart problems or low blood pressure is seen as a risk factor

It said that many groups had been left out from the original safety trials for Viagra, including men who had suffered heart attacks, stroke or dangerous arrhythmia within six months, men with dangerously high or low blood pressure, men with heart failure or unstable angina (chest pains), or retinitis pigmentosa, an eye disorder.
"The new labelling notes that if Viagra is prescribed for these patients, it should be done with caution," the FDA said. 

It also noted that patients who have heart disease are at risk from sexual activity anyway and have to be especially careful if they use Viagra.
The new label also warns of the risk of priapism - a prolonged and painful erection - and advises patients to seek prompt medical attention if their erection lasts longer than four hours. 

Plane crash connection investigated
Meanwhile, accident investigators in the United States say they are trying to determine whether Viagra contributed to a plane crash in which the pilot - a Hollywood actor, William Knight - was killed.
Mr Knight, 56, who has appeared in films such as Wall Street and Born on the Fourth of July, was killed when his experimental light aircraft hit the water during a difficult manoeuvre. 

A police spokeswoman has confirmed that officials of the National Transportation Safety Board have asked a medical examiner to determine whether Mr Knight - an experienced pilot - was using Viagra.
The American aviation authorities have advised pilots against using the drug within six hours of flying, because its side-effects can include difficulty in distinguishing between blue and green, which are used extensively in airport lighting and cockpit instruments. 

During testing, Pfizer reported that 3% of men reported visual disturbances that ranged from sensitivity to light to seeing a bluish-green haze.

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