Summary
This study sheds light on the development of the use of medicinal products for the treatment of erectile dysfunction in the period between 1998 and 2003. In October 1998, Viagra® was put on the market, and since then the sale of medicinal products for the treatment of erectile dysfunction has increased rapidly. Previous to the introduction of Viagra®, the only marketed treatments for this disorder were tablets containing yohimbine, which has a questionable effect, and medicinal products for direct injection into the penis. With Viagra®, more men have started treatment and the quantity consumption has almost tripled in 6 years. The primary group which undergoes treatment consists of men at the ages of 55 - 74. The number of people undergoing treatment of erectile dysfunction varies greatly from county to county. Relatively, almost twice as many men undergo treatment in the municipality of Frederiksberg compared to the island of Bornholm.
In 2003, two new preparations were marketed, namely Cialis® and Levitra®, which have the same mechanism of action and profile of adverse drug reactions as Viagra®. It is not documented that Cialis® and Levitra® are more effective than Viagra®, but Cialis® is effective for a longer period of time and may be taken up to 12 hours before sexual activity as opposed to ½ - 1 hour for both Viagra® and Levitra®. The marketing of these products has resulted in a decrease in Viagra’s market share. Altogether, the older medicinal products constitute a small percentage of sales – less than 6 per cent.
A large part of the men who use medicinal products for the treatment of erectile dysfunction apparently suffers from diseases which predispose this disorder. 11 per cent of the users have also handed in prescriptions for medicinal products against diabetes and 35 per cent have handed in prescriptions for medicinal products against high blood pressure or cardiac arrhythmia.
In general, no reimbursement is granted for medicinal products for the treatment of erectile dysfunction, but it is possible to apply for single reimbursement. In 2003, the Danish National Health Service’s expenditure on these medicinal products amounted to DKK 15.2m, which corresponds to 18.4 per cent of the total sale. The men who receive a reimbursement from the National Health Service have a higher consumption than those who do not receive any reimbursement. The consumption of Viagra® and Cialis® tablets is approximately three times as high for men who receive a reimbursement compared to those who do not.
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