How does Viagra on the NHS work?

There are two kinds of prescription you can get for Viagra on the NHS:

• An NHS prescription for Viagra – this is what people normally think of when they think Viagra on the NHS and it’s the same as a prescription you would get for most other medications.

• A private prescription from an NHS doctor – this is like buying Viagra privately anywhere else and doesn’t change if it’s coming from an NHS doctor or another healthcare service

Can I get Viagra on the NHS?

You can only get an NHS prescription for Viagra if you have one of a specific set of health conditions outlined in NHS prescribing guidelines.

Due to legislation from the UK government, the NHS has to restrict who it can give NHS prescriptions for Viagra to. Although Viagra can improve erectile dysfunction in a lot of men, regardless of any other health conditions, the NHS will only give an NHS prescription for Viagra to men:

• With:

• Diabetes

• Multiple sclerosis (MS)

• Parkinson's disease

• Polio

• Prostate cancer

• Spina bifida

• A spinal cord injury

• Certain genetic conditions, such as Huntington's disease

• Or who’ve had:

• A major pelvic surgery, such as surgery to remove tumours

• Removal of their prostate (prostatectomy)

• Recent dialysis or a kidney transplant for kidney failure 

The only other reason the NHS would give someone an NHS prescription for Viagra is if their erectile dysfunction is causing them serious distress. The factors used to tell whether you are severely distressed by your erectile dysfunction are if it causes:

• “Significant disruption to normal social and occupational activity” - your thoughts and feelings about your erectile dysfunction are affecting your work or social life

How do I get a private prescription for Viagra?

The easiest way to get Viagra without an NHS prescription is to use an online doctor service. You can also use services like this for other medications like Viagra:

• You can get assessed online, without seeing a doctor in person

• You can pick your preferred medication and a doctor will check if it’s safe for you

• If your online doctor agrees, your medication will be posted to your door

Not everyone can get a private prescription for Viagra either. This is because Viagra isn’t safe for everyone. Your doctor may not prescribe you Viagra privately if:

• You are allergic to any of the ingredients

• You have one of the following health conditions:

• Severe heart or liver problems

• A recent stroke or heart attack

• Low blood pressure

• Some rare eye conditions like retinitis pigmentosa

• An eye disorder called non-arteritic anterior ischaemic optic neuropathy (NAION)

• You are already taking some medications, including:

• Nitrates

• Riociguat

You can also get a private prescription for Viagra from your GP, or a private healthcare service. Any doctor licensed in the UK can prescribe Viagra privately – they don’t have to work in ‘private healthcare’.

Can I get other erectile dysfunction medications on the NHS?

Like Viagra, other PDE-5 inhibitors licensed for treating erectile dysfunction in the UK can only be bought with a private prescription. They include:

• Cialis

• Levitra

• Spedra

These Viagra alternatives all work slightly differently and some work better than others for different people.

What else does the NHS offer for erectile dysfunction?

The NHS offers some other erectile dysfunction treatments that don’t involve erectile dysfunction medication. They can also check your current health conditions and medications which could be causing your erectile dysfunction.

The other erectile dysfunction treatments the NHS offers include:

• Counselling or therapy for erectile dysfunction caused by emotional or psychological problems (and also counselling for emotional and psychological problems caused by your erectile dysfunction)

• Lifestyle advice which can help improve your erectile dysfunction such as:

• Losing weight

• Giving up smoking

• Cutting back on your alcohol consumption 

• Avoiding taking illegal drugs 

• Exercising on a regular basis

• Reducing stress

The NHS can also check you for some of the health conditions that might be causing your erectile dysfunction, and provide you with treatments. You can also get treatment for some of these conditions using an online doctor service. Conditions that can cause erectile dysfunction include:

• Heart disease

• High blood pressure (treatment available online)

• High cholesterol (treated with statins – available online)

• Diabetes

• Low testosterone

• Depression or anxiety

Some medications, like antidepressant for example, can also cause erectile dysfunction as a side effect. If you think your medication(s) are causing your erectile dysfunction, have your doctor check for you and they might be able to prescribe you something else.

Sources

Altwein, J.E. and Keuler, F. U. (2001). Oral treatment of erectile dysfunction with apomorphine SL. Urol Int; 67(4): 257-263.

Department of Health (1999). HSC 1999/148: Treatment for impotence. Crown Copyright: 1-7.

Electronic Medicines Compendium (2015). Opilon® 40mg tablets. Recipharm Limited. [online] Available at: https://www.medicines.org.uk/emc/PIL.18240.latest.pdf [Accessed 13th November 2017].

McKernan, S. (2015). Erectile Dysfunction Guidance. Lancashire Medicines Management Group. [online] Available at: http://www.lancsmmg.nhs.uk/wp-content/uploads/sites/3/2013/04/Erectile-Dysfunction-Guideline-Version-1.0.pdf [Accessed 13th November 2017].

NHS Choices (2016). Can I get medication for erectile dysfunction (ED) on the NHS? NHS. [online] Available at: https://www.nhs.uk/chq/Pages/882.aspx [Accessed 13th November 2017].

North Yorkshire and Humber Commissioning Support Unit (2014). Changes to the prescribing regulations for generic sildenafil for erectile dysfunction. NYHCSU Medicines Management Team for Vale of York CCG; v0.01: 1-2.

Wand, M. and Grant, W. M. (1980). Thymoxamine hydrochloride: an alpha-adrenergic blocker. Surv Ophthalmol, Oct; 25(2): 75-84.