The Wall Street Journal -- September 16, 1998
REVIEW & OUTLOOK (Editorial):
Viagra Triage
Pfizer's top brass may have either jumped for joy or blanched when a leading authority on male
sexuality, Playboy magazine publisher Hugh Hefner, called their impotence cure Viagra "the greatest
recreational drug ever." However they reacted, that term "recreational" may haunt them as the
wonder drug now enters the European market.
Yesterday, European Commission officials approved Viagra for sale throughout the European Union.
Now, Europe's overburdened socialized health care systems must decide whether or not to
reimburse patients for the expensive pills, which will sell for about $8 apiece. At least one member
state, Britain, says that for now at least, the National Health Service (NHS) won't pay for it. Health
Secretary Frank Dobson said he feared a rush for the drug could crowd out patients with more
urgent conditions.
Moreover, the costs might be enormous. Pfizer estimates that the annual cost to the NHS would run
around 50 million pounds ($83.5 million) per year. But others put the figure as high as one billion
pounds. Mr. Dobson neglected to mention the possibility of violence: As British physician Anthony
Daniels (pen name Theodore Dalrymple) recently wrote, 40% of British doctors have reported being
assaulted by demanding patients within the past 12 months, and we imagine they'd be a bit more
passionate about Viagra than penicillin.
Authorities in EU-aspirant Poland, which approved the sale of Viagra last week, have reacted
differently. The government's minister for family issues, Kazimierz Kapera, proposed subsidizing the
drug "to boost births in our homeland." The Solidarity-led government has already cut subsidies for
contraception after studies showing a 20% decline in marriage rates and a 30% decline in births since
the fall of Polish communism in 1989. "The current government cares more about pleasure of men
than health care for women," responded one feminist group.
In most respects, we see the world's reception of this drug as a healthy phenomenon. It is, after all,
refreshing to see an aid to life-affirming activity replace an anti-depressant as the world's best-selling
drug. But as important, Viagra may help force a rethinking of the outmoded health-care systems that
now dominate most of the developed world.
When medicine was primitive and treatments for many problems nonexistent, the promise of "free"
care (taxpayers paid, of course) was a relatively cheap and easy way for governments to win support
from electorates. But as doctors and scientists have developed ever more new drugs and techniques,
costs have skyrocketed and mortality rates have fallen. Without a market to allocate resources in
countries with socialized health care, rationing has been the only answer.
One British friend of ours was recently given an appointment for mere consultation about a serious
knee problem -- in 1999. And a Swedish friend was forced to put his career on hold for months for a
problem that would have been treated without delay in the United States.
Any debate about whether European governments should pay for everybody's Viagra is really beside
the point. Better that they should consider allowing those with the means to provide for their own
health care, allowing markets to keep prices low and quality high. Government could still play a role
in helping those who truly need it. |
