ORIGINAL ARTICLE
Int. J. Public Health
Exploring Patient Pathways and Care Situations in Men With Erectile Dysfunction in Different PDE-5 Inhibitor Regulatory Settings
- CB
Cosima Bauer 1
- UM
Uwe May 2
- QW
Quirin Werthner 3
- HW
Harald Weigmann 4
1. May und Bauer GmbH & Co. KG, Bad Honnef, Germany
2. Faculty of Economics and Management, Fresenius University of Applied Sciences, Wiesbaden, Germany
3. Independent researcher, Darmstadt, Germany
4. Opella, a Sanofi company, Frankfurt am Main, Germany
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Abstract
Objectives The study examined the impact of varying prescription requirements for phosphodiesterase-5 inhibitors (PDE-5is) on the management of erectile dysfunction (ED) in men. Methods A survey involving 10,000 men from Germany, Norway, Poland, and Switzerland was conducted using the International Index of Erectile Function Questionnaire to identify men with ED and interview them regarding their treatment and experiences. The use of PDE-5is by men without ED was also investigated. Results The proportion of PDE-5i users with ED was higher in Norway and Poland (over-the-counter availability) and Switzerland (prescribed by pharmacist) than that in Germany (doctor’s prescription required). Across all countries, men seeking to buy PDE-5is from pharmacies were advised to consult a doctor. The use of black market channels for purchasing PDE-5is was minimal in regions allowing non-prescription availability. The non-medical use was uncommon in all regions. Conclusions The need for a prescription for PDE-5is may hinder seeking treatment for ED and detecting underlying conditions. Therefore, PDE-5is should be approved as prescription-free medicines to improve the management of ED and to encourage men’s engagement with the healthcare system.
Summary
Keywords
Erectile Dysfunction, over the counter, PDE-5 inhibitors, Pharmacy, prescription
Received
20 March 2025
Accepted
02 December 2025
Copyright
© 2025 Bauer, May, Werthner and Weigmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Cosima Bauer, cosimabauer977@gmail.com
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.