The diffusion of a novel therapy into clinical practice: the case of sildenafil

UMMS Affiliation

Department of Medicine; Meyers Primary Care Institute

Publication Date


Document Type



Adult; Aged; Aged, 80 and over; Drug Therapy; Erectile Dysfunction; Health Maintenance Organizations; Humans; Male; Massachusetts; Middle Aged; Phosphodiesterase Inhibitors; *Physician's Practice Patterns; Piperazines; Purines; Sulfones


Life Sciences | Medicine and Health Sciences


BACKGROUND: Erectile dysfunction is a common condition, yet in the past most affected men did not seek medical treatment. OBJECTIVE: To examine how sildenafil (Viagra), a new medication for the treatment of erectile dysfunction, has been incorporated into general medical practice. SUBJECTS AND METHODS: The study population consisted of all male members of a group-model Massachusetts health maintenance organization (HMO) whose first prescription for sildenafil was dispensed during the first 24 weeks of its availability through the HMO as a plan benefit (April 24, 1998, through October 8, 1998). Data collected on each member in the study population included age, specialty of the prescribing physician, initial dose, use of prior treatments for erectile dysfunction, receipt of medications known to predispose to impotence, filling of a second prescription for sildenafil, and concomitant medical conditions (including hypertension, ischemic heart disease, hyperlipidemia, diabetes mellitus, and history of radical prostatectomy). Cross tabulations and logistic regression models were constructed to evaluate the potential associations between filling a second prescription for sildenafil and other characteristics of sildenafil users. RESULTS: We identified 899 members who filled a first-time sildenafil prescription in the 24-week period of interest. The majority of sildenafil prescriptions that were filled for the first time (85%) occurred in the first 12 weeks of its availability. Most sildenafil users (84%) were between 45 and 74 years of age (average age, 61 years; age range, 23 to 90 years), and approximately 40% had documentation of prior treatment for erectile dysfunction. Use was highest among those aged 55 to 64 years, with almost 5% of all male HMO members in that age group having received at least 1 sildenafil prescription. Our cohort of sildenafil users was significantly more likely to have hypertension (P

DOI of Published Version



Arch Intern Med. 2000 Dec 11-25;160(22):3401-5.

Journal/Book/Conference Title

Archives of internal medicine

Related Resources

Link to article in PubMed

PubMed ID