Derbyshire Medicines Management and Clinical Policies
For patients with erectile dysfunction needing a second line option to generic sildenafil: those who meet the SLS criteria should be provided with an NHS prescription in line with the traffic light classifications below. For patients who do NOT meet the SLS criteria, a private prescription can be provided in these circumstances for the formulation deemed most clinically appropriate. This includes once daily preparations and branded products as patients will meet the cost of the prescription themselves. NHS patients should not be charged for the issue of a private prescription in these circumstances. (SLS criteria for erectile dysfunction can be found in part XVIIIB of the drug tariff or in the BNF chapter 7 here
GREY: 10mg and 20mg tablets for erectile dysfunction (for patients meeting SLS criteria and therefore eligible for NHS prescription) - PDE5 inhibitors are generally considered equivalent. 2nd line choice for patients intolerant to sildenafil (1st line) should be based on cost. Cost effective to prescribe generically.
GREY: 5mg once daily preparation for erectile dysfunction (for patients meeting SLS criteria and therefore eligible for NHS prescription) is an option and cost effective when a PDE5 inhibitor requirement for a patient is greater than 8 doses per month. (Decision date - August 2023)
DO NOT PRESCRIBE (DNP): tadalafil (2.5mg) once daily preparations for erectile dysfunction (for patients meeting SLS criteria and therefore eligible for NHS prescription) - significantly more expensive compared to other available treatment. (Decision date - December 2017/August 2023)
DO NOT PRESCRIBE (DNP): Not to be prescribed by brand - Cialis for erectile dysfunction (for patients meeting SLS criteria and therefore eligible for NHS prescription) (Decision date - August 2019)
DO NOT PRESCRIBE (DNP):6 NICE TA273: Terminated appraisal for benign prostatic hyperplasia (decision date - February 2013)
