48,000 people get ‘Viagra’ on the HSE
AT a time when funding for life-saving drugs is restricted, it has emerged that almost 48,000 patients are being given Viagra, or a variant of it, at the taxpayer’s expense. The cost to the State of so many people availing of the erectile-dysfunction drugs for free through the medical card scheme stood at €2.1million for last year.
ALMOST 48,000 patients received drugs for the treatment of erectile dysfunction for free on the medical card last year – a rise of almost 6% compared to 2016.
The provision of drugs such as the generic version of Viagra and Levitra to 47,997 medical card holders for the sex disorder cost the taxpayer more than €2.1million during 2017.
This brings the total spend on these medications under the scheme to €44million in the past eight years.
The revelation will fuel questions as to why so many people are being given drugs for free which are not considered life-saving medication.
In recent years there have been a large number of cases of patients being unable to access potentially life-saving treatments such as cancer drugs. It comes as the HSE struggles to find the funds for life-saving drugs for cancer and other diseases.
Last year, a row broke out between the Department of Health and the HSE about who should foot the bill for nine vitally important drugs that would cost €120million over five years but can save hundreds of lives.
The department said the HSE already had the funds for the nine drugs, which include Entresto for heart failure, Lynparza for ovarian cancer, Gazyvaro for follicular lymphoma, Entyvio for Crohn’s and ulcerative colitis, Opdivo for renal cell carcinoma and Opdivo for Hodgkin’s lymphoma.
The HSE rejected claims it had the money and called for additional funding from the department.
Meanwhile, there has been a significant reduction in the cost of the erectile-dysfunction drugs in recent years.
Viagra came off patent in June 2013, allowing GPs to prescribe cheaper generic alternatives.
It was also announced last March that doctors would no longer be allowed to prescribe Cialis for medical card holders.
This lasts longer than other ED drugs, but is substantially more expensive – costing up to €33 per pack, compared to just €8 for generic versions.
Accordingly, the cost of pro- viding medical-card patients with drugs for the treatment of erectile dysfunction was more than halved last year from €4.5million to €2.1million.
Records released by the Health Service Executive under the Freedom of Information Act show that the Local Health Office area with the highest number of medical-card holders in receipt of erectile dysfunction drugs last year was Dublin North.
A total of 2,400 people were prescribed ED drugs on the medical card in this area in 2017, an increase of 7% since the previous year. Dublin North was closely followed by the Cork North Lee health area, where 2,395 patients received drugs for ED under the scheme, representing a 4% rise compared to 2016.
The LHO area with the lowest number of medical-card patients prescribed ED drugs last year was west Cork, where just 503 people received the medications under the scheme at a cost of €19,752.
Medical-card patients are entitled to four erectile-dysfunction tablets per month.
The most commonly prescribed drugs last year were those containing Sildenafil, which is the active ingredient in Viagra.
Tadalafil, which is the active ingredient in Cialis, was the second-most prescribed ED medication despite the removal of this drug from the list of products covered by the medical card from April 2017.
The HSE, which did not avail of an opportunity to comment, has ended the practice of doctors prescribing the more expensive anti-impotence drugs through the medical card system after the HSE last year issued a circular to GPs and pharmacists informing them of the move that the expensive Cialis can no longer be prescribed on the medical card for erectile dysfunction.
In the circular, a senior HSE official told doctors that if the HSE was to continue to fund the expensive ED drugs through the medical card, ‘it would reduce the capacity of the HSE to fund other services and technologies’.
Highest uptake in north Dublin
NEW figures show that more than 48,000 men were prescribed anti-impotence drugs last year on medical cards, at a cost to the taxpayer of some €2million.
No doubt this has brought joy back into the lives of the men in question, and into the lives of their partners, but at a time when there is such a strain on resources for health, is it really the best use of HSE funding?
As many are painfully aware, thousands of patients are struggling to gain access to life-saving medicines.
Moreover, as Vicky Phelan has pointed out, there are women in her position who do not have access to the cutting-edge drugs that she can afford thanks to the financial settlement she received in the CervicalCheck scandal.
Parents and children daily have to fight for access to drugs for conditions such as cystic fibrosis, and hundreds more children await operations for scoliosis, despite the fact that early intervention leads to the best possible outcomes.
The pie is a finite size, and there are only so many ways to slice it, and that means drugs that save or prolong life should take precedence.
The likes of Viagra might be a lifechanging drug, but erectile dysfunction is not a matter of life and death. It certainly leads to a better quality of recreational life, but it is not necessary for life itself.
The HSE has at least been able to cut costs by supplying generic versions. That much at least is welcome, and shows that the health executive recognises that choices have to made to provide a decent standard of care for everyone, and the best way to do that is to cut costs.
However, if the price of erectile dysfunction drugs actually has dropped thanks to generics, is it time to maybe ask the men involved to pay for their own?
They might grumble if the supply were to be shut off, but it is not a matter of life and death.
And while saving €2million would not exactly rescue the health service, it at least would demonstrate that the HSE’s priority is to make sure those who need actual life-saving treatment are first in line.