To: BigKNY3 who wrote (5233 ) 8/27/1998 9:10:00 AM From: BigKNY3 Respond to of 9523
More Details on the EU Approval EU Approval of Viagra Due In September August 27, 1998 Marketletter via NewsEdge Corporation : Approval in the European Union for Pfizer's Viagra (sildenafil citrate) has been supported by a scientific committee representing the health ministries of all 15 EU member states. Final EU approval is now expected on September 15, according to media reports. The approval recommendation followed a positive opinion from the European Medicines Evaluation Agency's Committee on Proprietary Medicinal Products on the marketing application from Pfizer UK and Roerig Farmaceutici at the end of May (Marketletter June 8). Change To Label Wording The recommendation for approval was not, however, unanimous, with Germany reportedly having asked for more information included in the instructions about the contraindications of the drug. The word " painful" is now included on the label which now includes the statement that "rarely, prolonged and painful erections have been reported after taking Viagra. If you have such an erection which lasts continuously for more than four hours, you should contact a doctor immediately," according to the Wall Street Journal. The Marketletter's European correspondent notes that in order to avoid tortuous and lengthy negotiations, Pfizer has not applied for Viagra to be reimbursed in France or southern Europe. The level of reimbursement is to be discussed with the UK, where it is estimated it will cost the taxpayer L1 billion ($1.64 billion). German regional funds and the Swiss Health Ministry have rejected reimbursement (Marketletter August 10). In the USA Viagra is reimbursed up to a mean 40% of its price. Recent reports from the US Food and Drug Administration on Viagra's "death toll" do not seem to have upset Pfizer's campaign for EU approval. According to the Wall Street Journal, the FDA has received voluntary notification of 123 deaths in patients prescribed Viagra between late March and July out of a total of 3.6 million prescriptions. Actual use of the drug could not be verified in 12 patients. Of the 69 American patients evaluable, the cause of death was unknown in 21, stroke in two patients and cardiovascular events in 46 patients. The mean age of the 55 patients whose age was known was 64. Concomitant use of nitroglycerin or other nitrate medications, either self- medicated or administered, was present in 12 cases and 51 (74%) patients had one or more risk factors for cardiovascular or cerebrovascular disease such as hypertension, hypercholesterolemia, cigarette smoking, diabetes mellitus, obesity or previous cardiac history. 36% of the patients died or developed symptoms leading to death four to five hours after taking the drug. The dose was known in 31 patients, of whom 26 had taken the 50mg dose, three the 100mg dose and two 50mg-100mg. Some patients died three to four days after initial drug use. Only five (7.2%) patients who died had no history of heart disease or other risk factors.