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

To: BigKNY3 who wrote (15574)	9/23/1998 9:29:00 PM
From: alan laValley	Read Replies (1) \| Respond to of 23519

Big K: Would like more information on American Medical Systems, the company that you believe will market Muse in USA. Also, are you affiliated with Warburg Pincus, their biotech fund is very close to your holdings.

To: BigKNY3 who wrote (15574)	9/23/1998 11:41:00 PM
From: Zebra 365	Read Replies (1) \| Respond to of 23519

Big K, I'm not picking on you. I like to address posts to you because I usually get a well thought-out reply. The language that you quoted is exactly the kind of non-warning, warning that we get from Pharma these days, "There is a degree of cardiac risk associated with sexual activity; therefore, physicians may wish to consider the cardiovascular status of their patients prior to initiating any treatment for erectile dysfunction." This is typical of language that seeks to transfer the risk from the Pharma to the prescribing doctor without offering any guidance on the standard of care in assessing that risk. "Hello, Mr. Jones we're calling to remind you that you have an appointment with Dr. Z. on Tuesday at 10:00." "Why?" "Well, he wants to consider your cardiac status." "Is this some kind of joke?" So we call the HMO for pre-authorization. "The doctor needs to do a stress test on Mr. Jones." "Why, does he have angina?" "No, he doesn't have chest pain, he has hypertension and diabetes and trouble with erections." "No, we are NOT trying to see if exercise makes him horny." "Click!". This is not just PFE but the lawyers who write all the drug info these days. And NO ONE wants a pregnant woman within 50 feet of their medication at ANY time from heavy petting through kindergarten. 20-30 times a day I assume liability risks greater than my net worth. I estimate I have had over 90,000 professional encounters in my career so far. You bet I'm sensitive to the risks of medications. I do prescribe Viagra, but I also have patients sign a risk disclosure form for it. I've only done this for Redux (a couple of patients who came to me on the drug, I never initiated that drug once), and Coumadin. So I do consider All ED patients to have increased cardiovascular risk unless they are spinal cord injury patients of which I, as as an internist, have none. But I can barely get them to come in for an evaluation and instruction, their friends get it from other docs by just calling and demanding it. Luck to you, too. Zebra