Annals of Internal Medicine, tip sheet, June 20, 2000

Erectile Dysfunction Drug May Be Cost-Effective, But Should Health Insurance Pay for It?

In a new study using a decision analysis model, the erectile dysfunction drug sildenafil (Viagra), compared with no treatment, was as cost-effective as kidney dialysis, cholesterol lowering medication or coronary artery bypass surgery (Article, p. 933). An editorial asks, when 1 in 5 Americans are not covered by health insurance, should health insurance, originally developed to minimize the financial burden of serious illness, pay for lifestyle enhancements like treatment for erectile dysfunction? (Editorial, p. 994.)

Also in the June 20 Annals of Internal Medicine:

• Hemophilia patients infected with HIV and hepatitis G virus (HGV), a virus that is prevalent but not known to be associated with any chronic disease, had better AIDS-free survival rates than those not infected with HGV. (Brief Communication, p. 959.)

• Peace Corps volunteers in Guatemala were followed for two years for occurrences of diarrheal illness. Among other conclusions, the detailed study confirmed common wisdom that risk factors include drinking water from an unknown source; eating food prepared by a local friend or family; eating at small, working-class restaurants; and drinking iced beverages or eating ice cream or flavored ices. (Abroad, p. 982.)

• An "informationist" or research associate working with a clinical team is needed to synthesize new information and research answers to questions arising at the bedside or in the office as care is given. The proliferation of medical information and the shrinking time available to search the medical literature mean that important medical information may not be incorporated expeditiously into real-life health care. (Editorial, p. 996.)

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. Full content of the issue will be available on the Internet at http://www.acponline.org on June 20, 2000.