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Launching Pfizer's Viagra

The Sunday Times

Sex drugs & rock 'n' roll

Then Leno produces a manila folder and holds it up for a camera. It's stencilled with the words "Pfizer Pharmaceuticals". He namechecks the company six times. Here he explains are rejected slogans from its new promotional campaign.

"Hot dog helper."

"Sex... in about an hour."

"Church won't be the only place that granny shouts 'bingo'."

Leno has done a Viagra joke almost every other night since the spring - which makes you wonder whether Pfizer needs a promotional campaign at all. But it has earmarked $35m to rally the public against the insurers. One of the first to get a share has been Time magazine, which helped launch the hysteria with a May cover story and package of excitable reports. One article concluded that claims for new products may have the familiar ring of "youth-in-a-bottle" advertising, "only this time, the stuff will really work."

At Pfizer's stainless steel and tinted glass world headquarters on East 82nd Street, Manhattan, the company's board and management must think they've died and gone to heaven. By mid-May, the hysteria had propelled weekly sales to a staggering 278,000 new prescriptions and, although by the end of June they had already slipped back to 150,000 weekly, there's never been anything like it. The company's stock bobbed around $50 on Wall Street a year ago (after profits of $2.2bn on sales of $12.5bn), but has recently topped $120.

Meanwhile, in the research department at Sandwich, England, celebrations must centre on the one-in-a-thousand fluke with which the sildenafil goal was scored. Patents filed in London as recently as 1991, 1992 and 1994 show that the compound - coded UK-92,480-10 - was one of a number which grew from the work of other drug firms, notably Warner Lambert and Abbott Laboratories. And they were synthesised before Osterloh's team had the foggiest about what they were supposed to do.

"Thus," the patents declare, "the compounds have utility in the treatment of a number of disorders, including stable, unstable and variant (Prinzmetal) angina, hypertension, pulmonary hypertension, congestive heart failure, atherosclerosis, conditions of reduced blood vessel patency, eg post-percutaneous transluminal coronary angioplasty (post-PTCA), peripheral vascular disease, stroke, bronchitis, chronic asthma, allergic rhinitis, glaucoma, and diseases characterised by disorders of gut motility, eg irritable bowel syndrome."

But this summer the toasts will be most raucous in Pfizer's marketing departments. For 30 years, the industry's holy grail has been products which get as close as possible to potential universal consumption. While high-price medicines for rare ailments can make money and those for common, and preferably incurable, conditions can yield unbelievable returns, what makes pharmaceutical salespeople shout 'bingo' is something to be swallowed by us all. The contraceptive pill was the great leap forward. Antidepressants were a sprightly hop.

Here's the great glory of Pfizer's riser: it's declared to be everyone's tonic. With men on a sliding scale of erectile dysfunction and the market primed with breathless stories about potential benefits for women, the reason for its license, dreary old impotence, need detain the world's attention no more. Even with Bob and Sharlene in the shop window, everyone knows that the big-time target is men with nothing much wrong.

"The best way I can describe the feeling of the sensation of Viagra is to compare it to when you're a 12-year-old boy and you're having your first erections," is how Clark, a Californian man in his 20s expresses a more typical anecdote. "It feels like you have an erection that can't be tied down with a rope."

Viagra isn't niched with sickness and disease products, but rather with those for fitness and lifestyle. And as a trip through a typical bookstore reveals, they are doing some incredible trade. In one New York Barnes & Noble I see browsers with Viagra: The Potency Pill, by the editors of the Consumer Guide; Viagra: A Guide to the Phenomenal Potency-Promoting Drug, by Susan C Vaughan, MD; Viagra - The Potency promise, by Larry Katzenstein; and The Virility Solution, by Steven Lamm, MD, with a do-it-yourself erectile index.

Lamm's book is the most revealing in its portrait of target users. Say goodbye to Bob and Sharlene and bid hello to "Dennis" and "Jennifer". These are stressed-out achievers in California's silicon valley who appear to be looking for thrills. He portrays Dennis coming home on a Friday evening to unexpected soft music and his wife preparing to make a dramatic entrance in the lounge.

"Very soon she did," Lamm gushes, "carrying a tray with a bottle of wine, two glasses, and a small china plate with a small blue pill for Dennis. Both he and Jennifer knew that it would ensure them a night of intense sexual pleasure, and the anticipation of those events brought a flush to both their faces. With that pill, their weekend, their sex lives, and most of all their ongoing relationship would be enhanced and enriched.

"Jennifer poured the wine and passed Dennis a glass. He leaned over, picked up the pill and, toasting his wife, swallowed it. Both Jennifer and Dennis were willing participants in the new world of sexual medicine, which gave them the security of knowing that they could have what they wanted, when they wanted it."

Lamm concludes: "Everyone can."

Gripped by his prose and by three references to Padma-Nathan I journey to the doctor's Upper East Side office, 20 yards from Central Park. He's also the author of Thinner at Last (1995) and Younger at Last (1997) and claims 100 network appearances. His room is emblazoned with signed celebrity photographs: Frank Sinatra, Rod Stewart, Steve Martin. He charges $150 for a first consultation. He dispatches Viagra by FedEx.

Lamm, who is 49, calls his speciality "vitality medicine" and he pursues the same holy grail as the industry: customers who are basically well. "I have a vision of the doctor as a coach, rather than just as a repairman," he tells me. "How do I take someone like you and get you to come and see me? Vitality medicine is getting people like you to function at a higher level, at peak performance."

This sounds good, but when I take the Viagra challenge - picking up twenty 50mg tablets elsewhere at a cost of $180.69 - to be honest I feel let down. Despite a first-time rush from consuming a sex-related product - producing more or less what Clark describes - on the next occasion, three days later, it doesn't make a great deal of difference. For my third experiment, after another few days, I take two (ie 100gms). But this time nothing seems harder or bigger. On the fourth time there's no effect.

Studying the science in my reporter's identity, this experience makes sense to me. The mechanism involved in the cavernosal smooth muscle is only a link in an elaborate chain - understood by experts with about as much clarity as how our minds control our bodies. There are countless messages flashing round our nerves, hormones generated in obscure glands and any number of chemical events. Blocking one enzyme, even phosphodiesterase type 5, is no more of a conclusive penis-booster than oil is the certain solution for grinding or funny smells in the car.

I also feel cheated that the drug isn't an aphrodisiac. It has the kick of decaffeinated coffee. And, in my case, it seems to have a deadening effect on sexual sensitivity. Although encouraging more blood into the penis sounds like fun, the sensation to me is something like wearing an invisible extra condom.

Then, when I consider why my penis is often soft, I think maybe it's because I'm not turned on.

Sales figures suggest that I'm not alone in my disappointment. Even my doctor in New York says the same. "I tried it when it first came out, but I don't take it any more," he explains. "I'm reasonably functional for a man of 65."

There's no pill yet for an unattractive partner (except possibly cyanide) and Viagra's limitations may wreck a few marriages when it fails to galvanise. But from Pfizer's point of view there need be no alarm. The market may still get bigger. The influential Dr Goldstein, professor of urology at Boston University Medical Center, argues that Viagra may be used to prevent impotence and be consumed on a just-in-case basis. "People take aspirin to prevent heart attacks," he tells Reuters. "Is Viagra the aspirin of the penis? We think it is."

Then there is the much-hyped use by women, which Padma-Nathan thinks needs more research. As The Sunday Times reported on 7th June, the campaign is on to convince the world that the wonder drug is not just for men. "Initial results from the secret clinical trials commissioned by Pfizer," the newspaper says,. "suggest the treatment is impressively effective, heralding a sexual revolution."

Whether this is true remains to be seen, and in the meantime many experts are cautious. When I catch a cab uptown to the 800-bed Montefiore Medical Center and Albert Einstein School of Medicine, in the Bronx, the professor and chairman of urology, Dr Arnold Melman, 56, sits behind his desk in a red-striped shirt and trashes the theory - in code. He's the past president of the International Society of Impotence Research and avoids inflammatory quotes.

"It's like the repeat dose of shampoos," he says.

"Err?" is my reply. I assume that he's setting-up a gag.

"Viagra for women," Melman continues (two, three, four). "It's the same as shampooing twice."

"How's that?" I'm still confused. A punchline missing?.

"It doubles the market." No joke.

*****

We're back in Los Angeles, two miles from Bob and Sharlene's (and as many light years from their lifestyle) at a gay men's sex club called The Zone. It's on Sycamore Avenue in Hollywood. Admission costs $8, plus $10 membership. Notices adorn the lobby. One warns of pickpockets. Another concerns condoms. And there's advice about the new craze drug.

"If you are taking Viagra," it shouts in red and black, "don't use poppers. The combination is deadly and frankly we don't feel like hauling your dead ass out of here."

It raises smiles, but the advice is for real. California has been rocked by three such deaths. When combined with sildenafil, the amyl nitrite or nitrate in the recreational chemical poppers can cause a blood-pressure slump and instant cardiovascular collapse.

Launching Pfizer's Viagra
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This report is copyright, Brian Deer. No portion of this article on the launch of Pfizer's erectile dysfunction drug Viagra in 1998 may be copied, retransmitted, reposted, duplicated or otherwise used without the express permission of the author. Responses, information and other feedback are appreciated