Physicians give Dobson backing on Viagra line
Celia Hall, Medical Editor
01/23/99
The Daily Telegraph
Page 08
THE president of the Royal College of Physicians yesterday backed the Government's decision to limit the provision of the controversial impotence drug Viagra , splitting the medical profession on how to deal with it.
On Thursday, the British Medical Association forcefully criticised the Government's plans for Viagra as unethical and cruel and told doctors to prescribe it while they can still legally do so.
But Prof George Alberti, royal college president, challenged critics to name the diseases which should be dropped from NHS treatment in order to pay for Viagra , which, freely prescribed, could cost the health service between pounds 50 million and pounds 125 million a year.
"Those promoting Viagra for all should ask themselves what service should be withdrawn and which patients should not be treated in order to pay for it," he said.
Frank Dobson, the Health Secretary, has proposed that the drug should be available on the NHS to impotent men who have had pelvic or prostate surgery and those with spinal injuries, diabetes, multiple sclerosis or single-gene neurological disease. Anyone else in severe need should be referred to a hospital consultant.
In addition, it would be made a Schedule 11 drug. This means GPs could only prescribe it legally to men on the list. But they could prescibe it privately to an NHS patient. The patient would pay for the tablets but not for the consultation.
Prof Albert said: "The guidelines are clear and allow the prescription of Viagra for a range or conditions with organic impotence. There is also provision for other patients who are caused severe distress by impotence, whose cases can be reviewed by specialists. What we have got here is a drug that could cost a lot of money. A lot of people would suffer as a result and this has not been taken on board by the BMA."
Prof Alberti also said the Government's decision was a clear indication of overt rationing which the college had strongly supported since its 1995 report Setting Prioities in the NHS. "The report acknowledged that rationing is inevitable in a cash-limited system," he said.
The Government has allowed a six-week consultation period on its plans for Viagra and the BMA has urged doctors to prescribe it while they can.
One of the first men to benefit from the doctors' rebellion said yesterday he "felt like a very lucky bloke".
He went to his GP expecting to pay for the anti-impotence drug -but came away with an NHS prescription after the doctor said he was following BMA advice.
The GP, Dr Jonathan Reggler, from Marlow, Bucks, said the man's case highlighted the absurdities of new rules for prescribing Viagra . "These rules are completely unworkable.
"Around three years ago, he had prostate cancer. Because it was in the early stages, he could choose between radiotherapy or surgery. He chose radiotherapy and became impotent.
"If he had chosen surgery, he would be eligible for Viagra on the NHS; with radiotherapy he isn't. But because he is also diabetic he is eligible. It is wholly absurd and cruel to deny people on the cause of their problem, rather than the clinical effectiveness of the treatment."
He added: "I think the BMA advice is spot-on. When I see a patient who is clinically in need of it, I will prescribe it." |
