A committee of NHS managers who are responsible for rationing
recommendations for areas that include Buckinghamshire and Oxfordshire,
have asked doctors to limit their patients to just two tablets per month
for those who are taking medications such as Viagra, Levitra, and Cialis to treat erectile dysfunction.
The prescribing of such medications on the NHS is already under
strict measures, with access to erectile dysfunction medication limited
primarily to those who are suffering from conditions such as diabetes,
multiple sclerosis, prostate cancer, Parkinson’s disease, polio, spina
bifida, and spinal injury. The South Central Priorities Committee, who
have made the new strict recommendations, covers PCTs in Milton Keynes,
Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire. They
suggest in their research that people between the ages of 40 to 60 have
sex once a week, which could lead to questions about how up to date or
accurate this research actually is and also why there is only a two
tablet per month idea put forth.
In addition, there is NHS guidance that states that there “appears to
be no clinical reason to restrict the number of tablets” of Viagra
prescribed to an individual. Dr Paul Roblin, chief executive of
Berkshire, Buckinghamshire and Oxon LMCs, said: “It is getting in the
way of GPs having a sensible dialogue with patients about their
requirements. Local priorities committees don’t understand the only
restrictions on GP prescribing come from the national black list and
grey list. They sometimes portray recommendations as a rule that has to
be obeyed, and that’s not true.”
A spokesperson for NHS Oxfordshire had this to say on the subject:
“Any decision made by the PCT cannot prohibit prescribing, but will form
a recommendation to GPs. The policy can be adapted locally and NHS
Berkshire East is implementing the two-dose policy for new patients
only.” Moreover, a NHS Berkshire East spokesperson has commented on the
new suggested procedure: “Existing patients are prescribed four tablets a
month, but new patients are treated in line with the policy published
by the Berkshire Priorities Committee.”
To evaluate whether the response to sildenafil administration in patients with arterial erectile dysfunction (ED) was related to their peak systolic velocity (PSV), peripheral atherosclerosis, cardiovascular risk factors (RF) and/or comorbidities at low cardiovascular risk.
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Median PSV was 24.1, 21.0, 19.3, 14.5 and 17.5 cm/s in groups A, B, C, D and E, respectively. Sildenafil response was higher in group A patients (77.8%), intermediate in groups B and C (65.2% and 56%) and lowest in groups D (45.4%) and E (50%), and the response in latter two groups was significantly lower than in the other three groups. In addition, sildenafil response was negatively influenced by: =or>3 RF, peripheral atherosclerosis and no systemic comorbidity, or presence of 1-2 RF associated with extended atherosclerosis and comorbidities. The number of comorbidities was positively related to atherosclerosis localization or extension (25, 35, 38 and 47 in groups A, B, C and D, respectively).
ReplyDeleteCONCLUSION:
Low sildenafil efficacy in patients with arterial ED was associated with extended atherosclerosis. These patients should undergo extensive ultrasonography and a full cardiovascular examination.
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