The number of medical-card holders who received drugs for the treatment of erectile dysfunction (ED) for free last year fell by 18%, but the taxpayer was still left with a €1.4m bill for nearly 40,000 people to avail of the pills under the scheme.

A total of 39,315 patients were prescribed ED drugs such as Viagra and Levitra on the medical card during 2018 – 8,682 fewer than the previous year. The total cost also fell from €2.1 million to €1.4 million.

The reduction in spending on ED drugs was also attributable to the fact that doctors are no longer permitted to prescribe Cialis for medical-card holders. This lasts longer than other pills, but is substantially more expensive – costing up to €33 per pack, compared to just €8 for generic versions.

The Local Health Office (LHO) area with the highest number of medical-card holders who received ED drugs last year was Cork North Lee, where 1,931 patients were prescribed the pills at a cost of €74,447.

This was followed by North Dublin and Dublin North Central, both of which had 1,926 medical-card holders in receipt of ED drugs last year at a cost of €69,172 and €66,476, respectively.

The LHO area with the lowest number of patients availing of ED drugs on the medical card was West Cork, where 391 people were prescribed pills under the free scheme.

Medical-card patients are entitled to four ED tablets per month. The most commonly prescribed drugs last year were those containing Sildenafil, which is the active ingredient in Viagra.

Tadalafil, which is the active ingredient in Cialis and Adcirca, was the second-most prescribed ED drug. The least-frequently prescribed medication was Vardenafil, which is the active ingredient in Levitra.

A total of 11,067 of the patients who received the drugs on the medical card last year were located in Dublin. Some 4,666 were based in LHO areas in Cork.

Some 1,248 people also received ED drugs free-of-charge under the Long-Term Illness scheme, which applies to patients with certain qualifying diseases and disabilities, including cerebral palsy, epilepsy and spina bifida.

The cost of providing ED drugs to patients under the medical-card scheme over the past nine years has exceeded €45 million. However, substantial savings have been achieved since certain brands were excluded from the scheme. The annual spend has fallen from €4.5 million in 2016 to €2.1 million in 2017, and €1.4 million last year.

The data was released by the Health Service Executive (HSE) under the Freedom of Information Act. A spokesperson for the agency declined to comment.