Limit of one Viagra a week for patients

FAMILY DOCTORS will be able to prescribe Viagra on the NHS to a limited number of impotent men from July, Health Secretary Frank Dobson said yesterday. Those who qualify, slightly more than originally proposed but fewer than one in five of all impotent men, will be limited to one pill a week "reflecting research evidence on this point," he said.

The announcement marks the end of one of the hardest-fought battles over the introduction of a new drug, and the frankest acknowledgment yet of the inevitability of rationing. By July, Viagra will have been on the market in the UK for 10 months, during which GPs have officially been advised not to prescribe it .

That advice, in a health circular issued at the drug's launch last September, is to be challenged by Pfizer, the Viagra manufacturer, in the High Court on Monday. Pfizer argues that the Government's decision to restrict prescribing while guidelines were being worked out was unprecedented and discriminatory.

Draft guidelines published in January proposed restricting NHS prescriptions of Viagra - and all other impotence treatments such as injections - to men with a narrow range of medical conditions. Mr Dobson said a balance had to be struck between meeting the needs of men with the "distressing condition" and protecting the resources of the NHS.

The proposals, revealed in The Independent yesterday, created fury at the British Medical Association (BMA) which said they were "unfair and irrational" and called for Viagra to be made available to all who needed it. However, it emerged yesterday that the BMA had misjudged the public mood. Of the 861 responses received by the Government during the consultation period, three quarters supported restrictions on prescribing, including 60 per cent of those from GPs.

However, Mr Dobson said "a lot" of the respondents felt the range of conditions for which prescribing would be allowed under the draft guidelines was too narrow. Yesterday he announced a slightly extended list and also included men with conditions not on the list, but who were already receiving impotence treatments on the NHS at 14 September last year, when Viagra was launched.

The new guidelines are expected to lead to a small rise in total spending on impotence treatments from the current pounds 12m, to pounds 14m a year. Men who do not qualify for NHS treatment can obtain the pills on private prescription for pounds 5-pounds 6 each.

John Chisolm, chairman of the BMA's GPs committee, said: "We have always said the decision taken should be based on clinical and cost effectiveness, fairness and clinical need. Clearly these new proposals are closer to doing that."

Stephen Thornton, chief executive of the NHS Confederation said: "This is the first time the UK Government has taken a decision of this kind at national level. There will be many other lifestyle drugs for which decisions will be needed."