The continued prescription requirement for Viagra due to its potential health implications.
Unleashing the Truth Behind Viagra: The Prescription Saga
The saga surrounding Viagra and other meds with active ingredient Sildenafil remains a hot topic. Recently, an expert committee (SVA) rejected a bid to unshackle these pills from the prescription prison, maintaining the status quo. To grab a pack of Viagra, you'll still need to visit a doc and snatch a prescrip.
But, there's more to the story than just a panel of experts deciding the fate of Sildenafil. It's about the awkwardness men with ED (erectile dysfunction) feel, an uncontrollable black market for performance enhancers, a pharmaceutical industry itching to peddle its wares without prescription, a physician shortage rendering appointments a premium, and telemedicine providers that flourish in the shortage's shadows. Let's dive in.
Pharma manufacturers, hammered by the latest decision to keep Viagra and alike in the prescription-only circle, lament. "We're disheartened by this decision. The SVA missed a chance to boost patient safety and promote personal responsibility," Elmar Kroth, second-in-command at Pharma Germany, said following the decision on Tuesday. The industry isn't ready to concede. "We'll keep advocating for Sildenafil's release from the prescription requirement and engage in dialogue with the powers that be," said Kroth.
Frontline Warriors: The Doc's Perspective
Medics are less enthused by this dance. "They just keep at it," grumbles Christian Wuelfing, chief physician of the Urological Department at Asklepios Clinic in Hamburg, towards the pharmaceutical lobby. Wuelfing had already criticized a previous industry push to sell potency drugs without prescription as the DGU's press spokesperson in 2023. Back then, the committee had spurned their request. Wuelfing asserts, "The decision to maintain Sildenafil's prescription status is a clear manifestation of prioritizing patient safety – and that's right." ED isn't some trivial lifestyle concern; it can be a red flag for serious illnesses, necessitating doctor-managed treatment.
The Molten Core: The Risks for Men and Urologists' War
"The primary motive for taking PDE-5 inhibitors, like Sildenafil, is ED, which has been scientifically validated as an early warning sign of cardiovascular diseases. Hence, it must be diagnosed," declares the German Society of Urology (DGU). People with low blood pressure, certain eye diseases, and heart problems should tread cautiously when it comes to Viagra. "Medical consultation and examination eliminate risks like hypotension, severe cardiovascular disorders, and certain eye diseases. They help identify accompanying diseases and treatment requirements of the individual patient," says the DGU.
Pharma Shines a Spotlight on Shame
Pharma Germany, however, points to the shame men with ED feel in this spat. "Many remain silent due to embarrassment," claims Korth. He suggests that over-the-counter sales in pharmacies could serve as a haven, giving these patients worry-free access to therapy while benefiting from pharmacists' advice.
Urologist Wuelfing disputes this. Pharmacists can only provide drug counseling; the crucial medical assessment can only be undertaken by a doc. "In terms of ED, we have a mixed bag. We have those wanting to pump up their performance and those grappling with a real disease. That's undoubtedly within the medical realm, not pharmacy. It's about evaluating medical facts – a doctor's task," says Wuelfing. If Viagra was available over-the-counter in pharmacies, Wuelfing warns, the previous "medical assessment would be bypassed and disabled," posing a health risk to patients.
Enter the Black Market
The topic isn't buried as Pharma Germany brings up the perilous black market. They argue that prescription requirements indirectly endanger patients, pushing them towards shady online solutions: men avoid docs due to embarrassment, resorting to dubious preparations snagged from the web. However, the black market, as customs reports indicate, has spun into astonishing proportions. It's not just about pills; it's about potency honey, chocolate, candies, or drink syrup laced with potency drugs. "Some products are marketed as naturally potency-enhancing," says the main customs office. They go by names like "Double Power", "Horny Performance Chocolate", "Jaguar Power", "Black Horse Vital Honey", "Secret Miracle Honey", and boast images of burning fists, roosters, horses, and big cats. In February last year alone, customs confiscated over 13 tons of these questionable potency-enhancing foods. Lab tests revealed they contained the potency drugs Sildenafil or Tadalafil. Usual hangouts for these products are Turkey, Thailand, Malaysia, or Tunisia, where these drugs are sometimes freely available at street-side stands or markets.
Urologist Wuelfing acknowledges that the issues of shame and the black market are genuine problems. He strongly advises against black market products: "Absolutely not, stay away from them!" However, he admits that patients confront the same shame dilemma when interacting with both doctors and pharmacists: "We've got a pretty awkward disease here, and patients prefer to avoid the doc or pharmacist who hands the medication across the counter."
The Telemedicine Solution: A Glimmer of Hope?
So, how can the complex issue of shame and the black market plaguing potency medications be solved? Wuelfing advocates for telemedicine. In his opinion, it might be the solution to the problems. By employing telemedicine providers, patients would dodge endless waiting periods for appointments and gain immediate access to medical advice. With the physician shortage causing serious delays in getting appointments, even those willing to face their ED issues might find it difficult to score a meet with a doc or physician.
The big issue of shame could also dwindle through telemedical consultations, which are essentially digital, believes the urologist. "When we talk about reducing access barriers, we need to focus more on innovative solutions like telemedicine that merge safety and accessibility. Its potential is enormous – we just need to harness it consistently," says Wuelfing.
What Wuelfing is advocating for has evidently already been discovered by many men. Key telemedicine providers, such as Zava and Teleclinic, list ED among the top reasons patients use their services.
Note of May 15, 2025: Christian Wuelfing, at the time of the interview's publication, was not only functioning as the chief physician of urology at the Asklepios Clinic Altona but also medically advisor on the board of Wellster Healthtech GmbH, a Munich-based company managing an online platform for prescription drugs and over-the-counter products (www.gospring.de) in partnership with a Dutch pharmacy. This might create a potential conflict of interest concerning Dr. Christian Wuelfing's statements in this interview, to which we would like to draw attention retrospectively.*
Despite the rejection from the expert committee to over-the-counter sales of Sildenafil, concerns about patient shyness and hidden black market activities persist. Urologist Christian Wuelfing suggests telemedicine as a potential solution to these issues. He believes that digital consultations could decrease access barriers, making it easier for patients to discuss their sexual health concerns without embarrassment. Telemedicine platforms, such as Zava and Teleclinic, already list ED as a top reason for patient consultation. However, it is important to address any potential conflicts of interest when considering the opinions of medical professionals with ties to telemedicine companies.
