Are more men seeking help for erectile dysfunction? A time trend analysis

Abstract

Background: Sildenafil and tadalafil are recommended first line treatment for Erectile Dysfunction (ED). Sildenafil was legally reclassified to a ‘pharmacy’ medicine in the United Kingdom in 2018. Aim: To assess the prescribing patterns and costs associated with prescribing of ED drugs in England and to investigate the link between prescribing and deprivation, regional demography and legal reclassification. Design and setting: Aanalysis of publicly available government data from various sources pertaining to primary care prescribing and demographics in England was conducted. Methods: Prescribing and cost data for the last 10 years (2009-2019) were extracted and adjusted for inflation, male populations and regional deprivation. Results: Between 2009 and 2019 the rate of prescribing, measured as the number of items per 1000 men, increased by 110%. In 2019, the rate of prescribing of ED medicines in the most deprived areas was 21.0% higher than the rate observed in least deprived areas. The Northern regions of England had approximately 50% higher rate of prescribing compared to London. A 0.5% annual increase in the number of prescription items was observed between 2018 and 2019, compared to 5.0% increase observed from 2017 to 2018. Conclusion: The two-fold increase in the rate of primary care prescriptions in the last 10 years suggests that more men are being screened for or seeking help for ED. Higher rate of prescribing offers opportunity for monitoring of linked risk factors such as diabetes mellitus, dyslipidaemia, and vascular disorders in deprived populations. Reclassification of sildenafil had a modest impact on prescribing practices.