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Biotech / Medical : VVUS: VIVUS INC. (NASDAQ) -- Ignore unavailable to you. Want to Upgrade?

To: Don Dunlap who wrote (13236)	8/13/1998 7:16:00 PM
From: DaiS	Read Replies (1) \| Respond to of 23519

>>We all knew this. The $64,000 question is why is Vivus incapable of establishing a market among Viagra failures? Personally, I don't see it happening. Script numbers would have turned by now. >> As Edderd and Zebra? have said to us, "We must be more patient". ...You say "I don't see it happening", but on what information do you base this expectation? It is very difficult? I think that there are a number of considerations here, Muse users at viagra introduction: They all tried viagra I guess apart from really serious cases. It worked for 55% of them and they switched to viagra, it failed for 45% of them and they returned to muse and formed the solid customer base we now see. Maybe some use both. Men who had not tried muse at viagra introduction: They all went for viagra. It has worked for some uncertain % more or less well. Those it has not worked for are not generating new muse scripts for the following reasons. 1. There is an army of Pfizer reps going around US promoting viagra and discouraging PCPs to use muse. ((The EMEA package leaflet for the EU for viagra actually says that viagra should not be used with other treatments for erectile dysfunction)) 2. Muse has had a fairly low uptake rate (10-20%), this may well have put off a lot of physicians from recommending muse. ((Vlad's point from his conversation with Vivus that Vivus are now recommending starting titration on the 500ug dose is IMO highly significant. Failing on the lower doses initially can explain the low recruitment from new users to regulars last year. It seems that this now being put right, but it might be difficult given that doctors generally are quite opinionated individuals. We have read that some docs won't prescribe muse. Possible if Vivus had not produced the lower doses we would not have had the AUA fiasco - in hindsight it is easy.)) 3. We read from the recent Humana? PFE news item that men are going to the doc and saying I don't want a check up just gimme viagra. Viagra discourages proper diagnosis - amazing. So it is not that men are rejecting muse, they are just not exposed to it. Until Vivus get a marketing partner in the US recruitment of new users will be difficult. ALL IMO OF COURSE DaiS