9th March 2009
The Department of Health’s (DH) guidance on treatment for impotence (HSC1999/148) recommends in paragraph 5 that one treatment per week will be appropriate for most patients being treated for erectile dysfunction.
However, the guidance also states that, “If the GP in exercising his clinical judgement considers that more than one treatment a week is appropriate he should prescribe that amount on the NHS.” This guidance is only appropriate to those men who are listed as eligible to receive the treatment on the NHS.
A daily dose treatment (Cialis Once-A-day ®) is now also available for impotence. In response to queries about this the DH state that, in exercising their clinical judgement, GPs may consider this suitable for a small number of patients.
What is the background to this?
Oral tadalafil (Cialis ®) 10mg and 20mg has been available for several years for the treatment of erectile dysfunction and is intended to be taken prior to anticipated sexual activity. It is not recommended for continuous daily use.
Recently Lilly have launched Cialis Once-A-day ® (tadalafil 2.5mg and 5mg) which is designed to be taken as a daily regimen in men who have responded to the on-demand regimen, and who may have intercourse more than once a week.
The Summary of Product Characteristics (SmPC) states that the appropriateness of continued use of a daily regimen should be reassessed periodically.
Drug treatments for erectile dysfunction, including tadalafil 10mg and 20mg (Cialis) may only be prescribed on the NHS to men with erectile dysfunction who have specific medical conditions. Detailed guidance has been issued by the DH. Prescriptions should be marked SLS and one treatment a week is considered appropriate for most patients. A GP may prescribe more than that if, in his judgement, it is appropriate.
Cialis 10mg and 20mg cost £24.99 for a 4-tab pack and £49.77 for an 8-tab pack.
Cialis Once-A-Day costs £54.99 for a 28-day pack.