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Biotech / Medical : VVUS: VIVUS INC. (NASDAQ)
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To: VLAD who wrote (9215)6/5/1998 8:51:00 AM
From: DaiS  Read Replies (1) of 23519
 
Vlad,

I have succeeded in getting in touch with a local physician who started and is running an ED clinic - this is not a private clinic, but part of the National Health Service. The doctor holds the clinic one day a week but also sees ED patients at other times. His partners in the practice direct all ED patients to him because of his interests in this area, he is not a consultant urologist. We are dealing with a catchment of 5-10K people for the surgery, but some men from the town (200K) attend the clinic. I know this doctor because I visit this practice myself.

This was his experience,

He has recieved written information/ads from Pharmacia and Vivus via drug reps.
Pharmacia info: injections 75%-80% effective, muse 40% effective
Vivus info: injections and muse equally effective.

From his experience so far, 60% of men trying muse find it successful and stick to it. When I challenged him that muse was really not very effective he was surprised and insisted that it was OK. His only negative comment in this respect was that muse was rather less effective than injections in contrast to Vivus claims.

He does muse titrations with patients to find appropriate dose in the surgery. His experience was that men found muse was easy to use, easier than injections. It appeared that he retained some fondness for the pump which he used pre-muse, but said that many men found the pump fiddly to use and this was less of a problem with muse. One interesting thing is that he thought that the softer erection frequently obtained with muse compared with injection could actually be an advantage. He felt that the injection erection was frequently abnormally hard and of course could persist too long. He used the words 'the muse erection is natural...'.

I asked him about Actis. Generally he appeared to dissociate the use of bands and muse. He knew that the band prevents backflow of the drug out of the penis but said that only a small proportion of his patients (10% out of the 60% when I pushed him) use a band with muse and that these may keep the band on as with the pump. I did not want to embarrass him so I did not push him on Actis use.

I mentioned that I had looked at the AUA abstracts and we talked about the VA study. I told him that 25 of the men in the VA study had failed on injections, and he thought that these would fail on muse.

Of course he was awaiting viagra in three months time. He told me about the 6 deaths and the eye damage and said that it would be necessary to take great care in prescribing the drug in UK. He was concerned too about the emotional problems that he might have with dealing with viagra failures.

In the end he emphasised to me that all the methods have failures and it was necessary to be careful to choose the right one for the patient. At no time did he hint to me that muse was no good - these suggestions came from me and he was anxious to refute them.

Remember I am not a physician when assessing the above comments, but I tried my best to get accurate picture and feeling of the situation.

My researches re- UK script data are continuing but unsuccessful so far. I have been told that the information is not in the public domain and been told to refer to the manufacturer for information - but I will continue to look.

I hope all the good news coming out about the effectiveness of muse is not to late for Vivus and that there will be a rebound.

DaiS

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