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Men seeking the impotence drug Viagra will be able to get it online from a reputable source without the embarrassment of having to visit their GP, pharmacists are saying today.
A new website will offer diagnosis of erectile dysfunction, prescription for medication and dispensing of treatments via the internet.
Lloyds Pharmacy believes that the scheme will attract men too bashful to visit their GP or pharmacist for treatment, and also help to crack down on the sale of fake medicines online.
Viagra, Cialis and related treatments for erectile dysfunction are among the most popular counterfeit drugs, in part due to their reputation for recreational, rather than medicinal, use.
The drugs will be made available only to patients who can persuade doctors that they suffer from erectile dysfunction and require a prescription by answering an online questionnaire. If appropriate, a doctor will then make available a trial course of up to eight tablets, or further doses of up to sixteen tablets a time.
Although online pharmacies offering diagnosis or dispensing services already exist, Lloyds claims that its website will be the first reputable source for the drugs that is open to scrutiny by regulators.
The cost of the service is £45 for four tablets and patients will be told the name of the doctor who has prescribed their treatment. The normal price for four 50mg tablets of Viagra is between £15 to £30.
The website service, available from today at lloydspharmacy.com, has been developed in conjunction with doctors at Dr Thom, a sexual health clinic, and Chelsea and Westminster Hospital.
Questionnaires will cover medical history, blood pressure, cholesterol and glucose levels, to lower risk of side-effects when taking the medication. Patients with a history of medical complications or who need different treatment would not be eligible, the pharmacy says.
But doctors said yesterday that such a system was open to abuse and could put patients at risk. The drugs are known to have side-effects, including lowering or raising blood pressure, headaches and indigestion.
Steve Field, the President of the Royal College of GPs, said that he found the idea “abhorrent”.
“Diagnosis from a doctor should take place in a physical, psychological and social context and it is potentially dangerous to offer these drugs online. It could mean that patients who are vulnerable are prescribed medications inappropriately and which could interact with other drugs they are taking or produce unwanted side-effects.”
It is estimated that one in ten of the adult male population — between two to three million men — suffer from erectile dysfunction. However, only 10 per cent of these are estimated to be receiving treatment.
A survey of 934 men conducted by the pharmacy found that four in ten would rather suffer in silence than tell their GP about erectile problems.
The Times understands that Pfizer, which manufactures Viagra, has been applying to make the drug available “over-the-counter” in pharmacies without a prescription. Recent minutes for meetings of the official Commission On Human Medicines refer to “a medicine used in the treatment of erectile dysfunction” being considered for reclassification. Pfizer said that it would not comment “upon our regular interactions with regulatory bodies,” and it is not known when a decision might be made.
Andy Murdock, pharmacy director of Lloyds, said that in the meantime, men were turning to the internet for medication.
“Unfortunately, most online sources are unregulated and patients risk receiving fake medicines which contain little, if any, of the active ingredient,” he said. “In some cases [the counterfeits] contain harmful substances which can cause health problems.
“We hope this new service will give men the confidence to use the internet for erectile dysfunction treatments, safe in the knowledge that they will be receiving genuine drugs from a reliable source.” But Dr Field noted the increased cost of the new service and said that men with conditions such as diabetes, prostate cancer and multiple sclerosis could access treatments such as Viagra on the NHS, as can those suffering severe distress.
“Services like this could lead to overprescription or use of medicines as recreational drugs rather than for those with a physical health problem. It is very worrying.” The first doctor in the UK to offer both a diagnosis and prescriptions to patients over the internet was last year suspended from the medical register for nine months after supplying large amounts of dangerous addictive drugs.
A General Medical Council hearing was told Dr Julian Eden, medical director of the online service e-med.co.uk, adopted a “cavalier attitude” to prescribing antidepressant drugs and sedatives.
Mitesh Soma, founder of chemistdirect.co.uk, an online pharmacy which dispenses medicines if a patient already has a prescription from a GP, said that he was reluctant to offer diagnoses online.
“There is an issue of risk to the patient of them simply being able to complete a form online and getting Viagra through the post,” he said. “What if a 55-year-old man completes the form as a 30-year-old, or neglects to mention heart problems, angina, or other conditions for which medication could cause problems?” The Men's Health Forum has previously argued that Viagra is safer than many medicines that were currently available without a prescription.
The only serious problems could arise, it says, when men were also taking nitrate tablets for chest pain.
Mr Murdock admitted that erectile dysfunction drugs could lower blood pressure, “so if they are dispensed to patients whose blood pressure is already low it could be very dangerous”.
But he added that the new service would “eliminate” this risk.
“Just as when assessing a patient in a clinic we have to rely to some degree on the honesty of the patient but we do ensure that the details provided by the patient match the details on the credit card used for transactions,” he said.
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