Recent news that Viagra will soon be available over the counter will come as a great relief to the many men suffering from Erectile Dysfunction (ED). But its deregulation also raises some important questions in relation to the way in which men manage their health and whether this will change as a result of this medication being made more accessible.
Medication to treat ED is classified by the NHS as a ‘lifestyle’ drug. This means that availability is limited. For those wanting access to a greater number of tablets than are available from their GP (often just four tablets at a time) private routes, including online pharmacies, have become increasingly popular.
In fact, according to a recent report in the Guardian, Viagra use alone among men has tripled. GPs attribute the increase in use to three key drivers: greater awareness and access, price (the cost of Viagra fell by 85.9% in 2013) and a wider public acceptance of the beneficial effects of the drugs resulting in reduced stigma.
Having said that, while stigma around the condition has reduced, judging by the increase in popularity of online services prescribing the medication, men today are no more inclined to talk to their doctor or pharmacist about their intimate health, than they ever were.
It is true that the demand for discretion when purchasing this type of medication has found a natural home online. However, it has also fuelled a rise in illegal operators selling unregulated and counterfeit medicines. The MHRA (Medicines & Healthcare products Regulatory Agency) believes that making ED medication available over the counter will help to reduce the number of men accessing meds via illegal online sources. But they may well be missing the point.
If the barrier to purchasing Viagra and similar medication is indeed related to a reluctance on the part of men to discuss embarrassing issues face to face, then surely having to purchase the medication in pharmacy, whilst convenient, will only serve to compound the situation.
This is because ED is quite often the first sign that someone could be a diabetic or suffering from high cholesterol, as such it is critical that recent Blood Pressure readings are provided and that the right questions are asked of patients. Significantly, these are exactly the kind of questions that men are notoriously reluctant to discuss in an open environment such as a pharmacy.
If online is the preferred route for men to make such purchases, surely the focus should be on making sure that consumers understand how best to safely access their medication via reputable sources?
Currently, ED medication is only available on prescription. This provides a vital way of differentiating between websites that are operating illegally and those who are regulated by the industry bodies. Websites that sell the pills without a prescription cannot be verified and as such neither can the items they are dispensing. This provides a very clear signal to anyone using an online service in terms of the legitimacy of the site. So, if prescriptions for ED meds become obsolete, how can sufferers opting to use online sources be sure that what they are getting is the real deal?
This is an issue which the Care Quality Commission (CQC) has recently addressed through the introduction of rigorous assessments to clamp down on substandard practice. Patients can easily identify sites operating according to the law through the presence of logos of the official regulatory bodies governing the industry on the websites:
• The GPhC (General Pharmaceutical Council),
• The MHRA (Medicines & Healthcare products Regulatory Agency) and
• The CQC (Care Quality Commission)
To verify the legitimacy of a site, all consumers need to do is find and click on the logos and they will be taken through to the pharmacy’s registration pages.
So, the infrastructure is in place, but there is still a significant education job to be done.
Deregulating ED meds and enabling them to be bought over the counter makes access easier than ever before and, with the NHS under increasing pressure, any steps which enable pharmacists to use their expertise to provide additional patient support are to be welcomed. But we mustn’t forget the end user in all of this. If legitimate online sources are providing a valuable service which works for patients, shouldn’t we do what we can to ensure they get what they need in the safest way possible?