Here's the Houston Chronicle article 'A New Era'(thanks, Charles):
9:32 PM 4/21/1998
'A NEW ERA'
Impotence pill big hit in first 2
weeks on sale
By MARY SIT-DuVALL
Copyright 1998 Houston Chronicle
The pharmacy at Eckerd Drugs had been opened one hour
Tuesday when a dapper gentleman in a black wool suit
walked up to Emily Zakhem, chief pharmacist.
He hesitated, leaned forward and then requested "the new
drug."
"You mean Viagra?" Zakhem recalls asking him.
"Yes, that's it," said the customer.
Zakhem explained that the new impotence drug Viagra was
a prescription-only medicine. The gentleman insisted she call
his doctor. The pharmacist did -- and the 90-year-old man
was told he had to come in for an evaluation.
Sales of Pfizer's impotence pill have skyrocketed since it hit
the market two weeks ago, outpacing the launch of
blockbuster drugs such as the diet drug Redux and rivaling
Prozac, the top-selling anti-depressant.
Nationwide, pharmacists have filled 40,000 prescriptions in
the two weeks ending April 10, according to Scott-Levin, a
pharmaceutical market-research firm in Newtown, Pa. U.S.
health officials estimate 30 million men in the United States
suffer from impotence.
Locally, doctors say the phones are ringing constantly with
patients who are asking for the drug by name. Men who
haven't seen physicians for years are making appointments.
Patients from Mexico are flying in to get the drug, which is
available only in the United States. Europeans are extending
vacations until they make one more stop -- this time at a
doctor's office for an evaluation -- and a bottle of Viagra.
The response to Viagra has been fairly enormous, said Dr.
Melvyn A. Anhalt, president of the Houston Urological
Society and a physician at Memorial Urology Associates.
His office had compiled a list of 400 patients who were
waiting for Viagra to hit the market.
Last week, 90 of them received a postcard simply stating:
"The pill is here."
Anhalt said he has written 25 prescriptions -- and so far, 15
have called back to report success.
"It's amazing," Anhalt said. "There's a lot of excitement
about it."
The first effective pill to treat erectile dysfunction, Viagra
works by temporarily blocking an enzyme that occurs
naturally and causes the erection to go away. By taking
Viagra, patients can enhance the quality of the natural
erection. Viagra does not cause erections and men must still
be sexually stimulated.
"The drug marks the beginning of a new era in the treatment
of impotence -- erectile dysfunction," said Dr. Larry
Lipshultz, professor of urology at Baylor College of
Medicine. "We now have something that is user-friendly."
Patients take the pill only when they want to have sex. It
takes about an hour to become effective -- but if taken with
a high-fat meal will take about two hours. The effect lasts for
four to five hours.
The pills are not cheap. In Houston, a 30-day supply of
50-milligram pills is $249.99 at Eckerd; $264.98 at
Walgreen Drug Stores; and $262.50 at Buffalo Pharmacy
on Bissonnet.
Pharmacists said insurance plans have not decided how they
will reimburse the medicine, if at all, but paying out of
pocket hasn't deterred demand.
Lipshultz, involved in preclinical trials of the drug, said he
had written about 100 prescriptions as of Tuesday.
"The most common complaint we have is not the patient
who is not having any erections, but the patient who is
dissatisfied with the quality of erection -- the duration or
actual rigidity. Those are the people who make up the
majority of patients," Lipshultz said.
Dr. Edward Kim, assistant professor of urology at Baylor
College of Medicine, said a patient called Tuesday to cancel
surgery scheduled for today. The man, in his early 60s, had
tried three treatments for severe erectile dysfunction --
injections, insertion of a drug-filled pellet into the urethra,
and a vacuum device that slips over the penis. None had
worked on him.
After one week of taking Viagra, the patient called to cancel
his surgery, Kim said.
"I've had more sex in the last week than I've had in the last
few years," the patient told Kim.
Wall Street has also responded enthusiastically. Analysts are
touting this as the drug of the '90s -- as revolutionary as the
birth-control pill became when it was launched in the early
1960s.
Pfizer stock jumped Tuesday 2, closing at 116. A week
ago, it was 99.
"We think it's going to be the largest selling drug in our
generation -- the first $6 billion drug. This year our estimate
is $400 million in revenues, but we think it will exceed that,"
said Len Waffe, an analyst at NationsBanc Montgomery
Securities in San Francisco.
Viagra's popularity is even benefiting the makers of one of
its potential competitors.
The stock of Zonagen, the biotechnology firm in The
Woodlands that is making an impotence pill called
Vasomax, has jumped more than 50 percent in the past two
weeks.
Zonagen rose 2 1/2 to 31 1/4 on Tuesday. Two weeks ago,
it closed at 20.
Viagra's initial sales far exceed any launch of a drug and is
quickly becoming one of the best-selling drugs in history, say
analysts. Last year, for example, three new drugs were
launched: Rezulin, an anti-diabetic drug; Lipitor, a
cholesterol-reducing drug; and Redux, a diet drug. Both
Rezulin and Lipitor had about 10,000 prescriptions in their
first month on the market, while Redux, which has been
pulled off market, had 20,000 prescriptions, according to
Scott-Levin.
"In their first month, they weren't even half of what Viagra
was in its first two weeks," said Sherry Dixon, director of
audit services at Scott-Levin.
Pfizer, which would not release any sales figures, said
Viagra has been the firm's fastest selling drug in the past two
weeks.
"We're certainly very pleased with the initial response." said
spokeswoman Mariann Caprino, adding that it is too early
to predict the long-term success of the drug. Pfizer sells $2
billion a year of Norvasc for hypertension and $1.5 billion a
year of Zoloft for depression.
Analyst Eugene Melnitchenko of Sutor & Co. said he
expects the stock to stabilize in the 90s or 100s "once the
fluff is out."
Sales of Viagra have been posted over the Internet with
consumers logging on to a Web site for a $50 phone
consultation and prescription. The site (www.penispill.com)
is operated by Vascular Center for Men in Milwaukee.
Although legal to sell prescription drugs on-line, physicians
here say they would never prescribe the drug to patients
sight unseen.
"I see as a danger there are going to be so many men who
will want it, that physicians, in an effort to be efficient, will
try to process men as fast as possible and not do
questionnaires or take a good general history," warned
Lipshultz of Baylor. "They'll miss an underlying problem of
which impotence is a symptom."
For example, a low testosterone level could indicate a brain
tumor, diabetes or hypertension.
Men who have normal erections but simply want to impress
their partner should not be using this drug, doctors say.
"There's potential misuse of the medication -- for
recreational use rather than therapeutic," Kim said. "It works
best on those men who have a problem. It's not going to
give a super erection."
Side effects are minimal and temporary -- flushing,
heartburn, mild headaches. The drug cannot be used by
anyone who is taking nitroglycerin since the interaction can
cause a dangerous drop in blood pressure.
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