Fewer suicides with less expensive medications for erectile dysfunction

When medications for erectile dysfunction became less expensive and their use increased, the number of suicides among men aged 50-60 decreased in Sweden. This is the finding of a new study from the Uppsala University.

"This is another indication of how important sexual intimacy and close relationships can be throughout life, that for some people they can be so closely linked to life satisfaction and the ability to face life's setbacks," says Terry Hartig, Professor of Environmental Psychology at Uppsala University and one of the researchers behind the study.

During the period 2007–2012, an average of 62,000 men in Sweden used medications for erectile dysfunction. This number increased to 101,000 on average for the years 2014–2017, after the patent for the major bestselling brand Viagra expired and it became available freely on the market. Before the patent for Viagra, which has the active ingredient sildenafil, expired in July 2013, 12 tablets cost about SEK 1,200. Once the patent expired and competitors began producing generic versions with the same active substance, the market price fell to about SEK 300 for the same number of tablets, so a quarter of the previous price.

Decrease when the patent expired

In the study, which was conducted together with colleagues from the University of California, the researchers examined the number of suicides among men aged 50–59 in Sweden. Based on the suicide statistics for the period (102 months) before the expiration of the patent and the decrease in price, the researchers calculated how many suicides would have occurred if the change in price had not happened. They then compared the expected number of suicides with the number actually registered suicides during the 18 months after the change. The statistical material was fully anonymised and cannot be linked to specific individuals. The results showed that there were 65 fewer suicides than expected during the period.

There are many reasons the study focused on men between the ages of 50 and 60. The first is that this group increased its use of the medication the most during the period. The second is that, according to the Swedish National Board of Health and Welfare's statistics, this group has the most suicides compared with all other age groups. The researchers did not see a similar correlation in other age groups of men nor in any age group of women.

"Chance would only produce our results fewer than once in 10,000 experiments. Fairly unlikely in other words and difficult to explain the difference in any other way than the introduction of the generic sildenafil when you include how the analyses were conducted and the fact that we saw a correlation in that gender and and age group.

Intimacy is important

Previous research has shown how important sexual intimacy can be for mental health. Experimental studies in this, however, are fairly rare because of ethical, practical and even cultural constraints. At the same time, existing surveys have not provided convincing evidence of how strong the connection is and if good mental health is an effect or cause.

"The study shows how epidemiological research can use data from the entire population to explore delicate questions that are difficult to examine with studies of individuals. More epidemiological research can be worthwhile in efforts to help individuals take strengthen of their close relations, have more time and opportunities for the sexual intimacy that they want and in this way maintain a sense of belonging and engender happiness and self-worth," says Terry Hartig.

Elin Bäckström