BusinessWeek: May 4, 1998

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 News: Analysis & Commentary: PHARMACEUTICALS

BEYOND VIAGRA
Combos of impotence drugs will crop up next

No question, Pfizer Inc.'s new impotence drug, Viagra, looks to be a super blockbuster. In its first full week on the market in April, more than 36,000 prescriptions were written, and as of Apr. 22, Pfizer's stock was up 51% for the year.

But other new treatments are also in the works. And many of the 30 million American men who have experienced erectile dysfunction may find that the best solution is a combination of therapies--a sort of impotence cocktail. "I think the real story will be the polypharmacy of erection," says Dr. Gregory A. Broderick, director of the University of Pennsylvania's Center for the Study of Male Sexual Dysfunction.

Why the need for a cocktail? Viagra blocks an enzyme involved in preventing erections and worked for 70% of the men who tried it. But for men dissatisfied with Viagra, an alternative is now in final clinical trials. An oral version of an existing drug called apomorphine stimulates the center in the nervous system responsible for erections. TAP Pharmaceuticals, a joint venture of Abbott Laboratories and Takeda Chemical Industries Ltd., plans to study the effectiveness of Viagra and apomorphine in combination. Another medication, Vasomax, developed by Zonagen Inc., blocks receptors that prevent blood vessels in the penis from dilating. If approved by the Food & Drug Administration, Zonagen's drug will be marketed by Schering-Plough Corp.

But doctors warn that impotence cocktails should be tested carefully first. They cite last summer's debacle with the fen-phen diet drug combo. Fenfluramine hydrochloride, the fen in that combo, was pulled from the market after data showed that many patients taking fen-phen may have suffered heart valve damage. "Indiscriminate combinations can lead to medical disasters," warns Dr. Harin Padma-Nathan, a urologist in Santa Monica, Calif., who has overseen studies of Viagra and apomorphine.

With luck, this time, physicians, patients, and the pharmaceutical companies will be able to show a little more restraint.

By Amy Barrett in Philadelphia
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