Category
Threshold Criteria
Erectile dysfunction (impotence) is defined as an inability to obtain or maintain an erection sufficient for penetration and for the satisfaction of both sexual partners.
Eligibility
| LLR ICB will fund treatment as follows 1. Treatment with the phosphodiesterase type -5 inhibitor, generic sildenafil, at the minimum effective dose is recommended for any man presenting with erectile dysfunction with a frequency of dosing for a maximum of four times per month. 2. For all other phosphodiesterase type-5 inhibitors (vardenafil, tadalafil and avanafil) is only recommended for patients who meet the Government Selected List Scheme (SLS) criteria AND where generic sildenafil is ineffective, with a frequency of dosing maximum four times per month using the drug with the lowest acquisition cost. 3. Treatment with prostaglandin E1 intracavernosal injections and intraurethral instillations is only recommended for patients who meet the SLS criteria AND only if oral phosphodiesterase type-5 inhibitors are contraindicated or ineffective. The maximum frequency of dosing should be four times per month using the drug with the lowest acquisition cost. 4. Treatment with Alprostadil cream is not routinely funded due to limited evidence for clinical and cost effectiveness. 5. Treatment with vacuum erection devices may be considered for those men who are intolerant, unable to have Intracavernosal injection therapy (ICI) or oral agents. 6. Treatment with penile implants will be funded for post prostatectomy and complicated acute priapism. Penile implant surgery for end stage erectile dysfunction is NHSE funded. 7. Treatment with psychosexual interventions may be used in work up with tertiary referral patients, therefore GP’s should refer and manage in primary care as part of clinical care. |
Guidance
| ARP 39 Review Date: 2026 |
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