APPENDIX 57
Memorandum by Pfizer Limited (SH 92)
SUMMARY AND
RECOMMENDATIONS FOR
ACTION
Pfizer Ltd welcomed the first national strategy for
sexual health and HIV.
Erectile dysfunction should be included in the Government's
sexual health strategy given that it is a significant and serious
condition for over 3.3 million men in the UK.
Principle four of the strategy "Providing a
comprehensive service" does not consider patients with erectile
dysfunction. Treatment for this condition is rationed by the use
of schedule 11 on the basis of cost. Patients are denied access
to treatments that could make serious and meaningful improvements
to their lives. Pfizer would urge the committee to address the
issue of comprehensiveness within the terms of the inquiry.
Pfizer welcomed the initiatives relating to Chlamydia
screening. The strategy should make explicit reference to the
imperative to treat this disease as quickly and simply as possible.
Medicines with a single dosing regimen are available to treat
this disease more effectively than ever before. This disease is
not limited by gender and in order to prevent re-infection, both
women and their sexual partners should be screened and treated
quickly and effectively.
Pfizer believes that the success of educational initiatives
lies in the strength of the supporting partnerships from which
they are developed. Pfizer is committed to ensuring that healthcare
professionals gain confidence and expertise in managing and treating
sexual health problems and to communicate more effectively with
patients.
EVIDENCE PROVIDED
BY PFIZER
LTD.
1.Pfizer is a research-based global, pharmaceutical
company, which discovers and develops innovative medicines that
improve the lives of people around the world. The company has
substantial commitments throughout the UK. With world-class research
and development facilities in Sandwich, Kent, and commercial operations
near Reigate, Surrey, Pfizer is one of Britain's leading inward
investors.
2.Employing some 2,500 scientists, Pfizer at Sandwich
is one of the world's leading centres for the discovery, research
and development of a wide range of new and innovative medicines.
Groundbreaking discoveries from the Sandwich laboratories comprise
treatments for erectile dysfunction and opportunistic fungal infections
prevalent in immunocompromised patients. In addition, Pfizer manufactures
and distributes the world's leading antibiotic treatments for
a range of Sexually Transmitted Infections, including chlamydia.
3.Pfizer welcomed the first national strategy for
sexual health and HIV. For many years sexual health has been seen
in isolation and all too often undervalued in regard to the overall
contribution that good sexual health can make to the health and
well being of the nation.
4.Clearly as the strategy document reflects, sexual
health problems are all too common. Pfizer believes that this
partly is a natural consequence of the chronic under funding of
sexual health promotion services whose consistent aim has been
to break the taboos and stigma associated with sexual ill health.
An equally important factor lies in the long-term under-investment
in sexual health medical services which has until now been a much
disregarded asset of the NHS.
5.Pfizer notes with interest the aims and principles
of this strategy document. The seven principles set out are clear
and uncompromising in their nature; this approach should be strongly
endorsed. However in relation to principle four, "Providing
a comprehensive service" a mismatch in word and deed is in
evidence. Pfizer would respectfully take this opportunity to highlight
the plight of thousands of patients suffering from erectile dysfunction
(ED) who are unable to gain access to treatment purely on the
basis of cost.
6.Treatments for ED, in a huge number of cases, are
still unavailable to patients who are in need of them. This is
unacceptable. Rationing by the use of Schedule 11[31],
as has been witnessed in the treatment of ED, generates and strengthens
inequity inside the NHS. This type of activity undoubtedly undermines
any notion of comprehensiveness and sets a poor precedent for
those hoping to increase equity in sexual health and moreover
the NHS. Pfizer would urge the committee to address the issue
of comprehensiveness within the terms of the inquiry. The basis
for ED treatments being rationed by the use of Schedule 11 for
cost reasons (in contrast to many other treatments for non-life
threatening conditions) remains very unclear.
7.Pfizer warmly welcome the initiatives announced
within chapter four of the strategy, "Better Services"
relating the chlamydia screening. While this progression is certainly
a step in the right direction, Pfizer believes that this does
not go far enough. Specifically, the strategy should make explicit
reference to the imperative to treat this disease as quickly and
simply as possible. Certainly, medicines with a single dosing
regimen are available to treat this disease more effectively than
ever before. Furthermore Pfizer would like to remind the committee
that this disease is not limited by gender, as the strategy document
implies. It is essential that in order to prevent infection, both
women and their sexual partners are screened and treated quickly
and effectively.
8.Pfizer is disappointed to note that within the
section "Better Services" no reference is made to the
treatment of erectile dysfunction. ED is a significant and serious
condition for over 3.3 million men in the United Kingdom. It is
essential that the sexual health strategy demonstrates an inclusive
approach to patients requiring access to modern services and treatments
to this condition. The exclusion of ED from the document demonstrates
apathy on the part of the NHS towards many men and their partners,
who are all too often denied, comprehensive healthcare, available
on the basis of clinical need and not the ability to pay.
9.Education and training as outlined in section six,
is likely to play a large part in the delivery of such an ambitious
and on the whole, well thought out strategy. Pfizer for its part
is keen to play a leading role as a partner and initiator of key
training programmes aimed at developing skills in the diagnosis
and management of sexual health problems.
10.Pfizer would respectfully wish to draw the attention
of the committee to "Erectile Dysfunction in Primary Care"
and "Nurse Education and Erectile Dysfunction". Independent
faculties comprising of urologists, general practitioners, sexual
health physicians and nursing professionals have developed both
of these programmes. Pfizer has enabled the training of over 10,000
healthcare professionals in an increasingly exciting and innovative
area of sexual health medicine. The British Association of Urological
Surgeons, The Royal College of Nursing and the Impotence Association
also endorsed both of these programmes.
11.The success of educational initiatives lies in
the strength of the supporting partnerships from which they are
developed. Pfizer is committed to ensuring that healthcare professionals
gain confidence and expertise in managing and treating sexual
health problems, and helping them to communicate more effectively
with the patients in their care.
12.Pfizer believes that the concept of providing
a strategy for sexual health is a sound one and should be applauded.
However, as alluded to in the above response to the Health Select
Committee consultation, a number of serious doubts and reservations
remain. Pfizer would respectfully request that the consultation
process takes full account of those patients who are denied access
to treatments that could make serious and meaningful improvements
to their lives.
31 Schedule 11 to the NHS (General Medical Services)
Regulations 1992 is a list of drugs which GPs may prescribe on
the NHS only in specified circumstances and/or for specified patient
groups. Back
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