RESULTS: In 2021, 10,112,191 prescriptions of sildenafil and/or tadalafil were prescribed to 3,480,497 patients, equivalent to 3 prescriptions per patient per year. The overall average day supply for PDE5 inhibitors was 28 days (SD 18). An analysis of 50 US states and the District of Columbia found the average day supply ranged from 24 for MN to 36 for AK. Nationwide, the most common specialties prescribing PDE5 inhibitors were family medicine (34%), internal medicine (19%), nurse practitioner (16%), urology (15%), and physician assistant (8%). Family medicine was also the first-rank prescriber in 43 states. Urology was a second-rank prescriber in DC, LA, MD, NJ, TX, VA, and VT versus a third-rank prescriber in 16 states (AR, AZ, CA, CT, GA, IA, IL, IN, KS, MI, MS, NY, OK, PA, SC, WI).

CONCLUSIONS: Family medicine is the main prescriber of PDE5 inhibitors. Given discontinuation of PDE5 inhibitors for non-responsive ED management may occur, collaborative efforts to ensure continuity of care among different medical specialties are critical to ensure men with ED not responding to PDE5 inhibitors receive other ED treatments. Future research into specialties associated with discontinuation of PDE5 inhibitors and subsequent patient referrals could illuminate opportunities to improve ED care continuity.