All signs are good for OTC sales in wake of huge Viagra success

Drug Store News,  June 22, 1998  

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Former senator Bob Dole thinks Viagra is the greatest thing since the invention of the wheel. And, he ought to know... he's lived to see both in a single lifetime. But cheap Bob Dole jokes aside, the truth is that Viagra could well be the biggest thing to happen to chain pharmacy this year, creating huge profitmaking potential for sales on both sides of the pharmacy counter.

Plenty of ink already has been devoted to Viagra's successes at the back end of the store. Top Wall Streeters estimate that Pfizer's little magic blue pill will pull in more than $1 billion in sales this year, and that amount will more than triple over the next several years. At the time Drug Store News went to press, roughly one million new prescriptions had been written for Viagra since it became widely available this spring, apparently outpacing the decade's other uber-drug, Prozac, in terms of initial sales. According to some estimations, since the launch, Pfizer has taken over about 95 percent of the total prescription impotence market.

But, there are several reasons to think that the hullabaloo created over Viagra could spill over into the front end of the store as well.

First of all, Pfizer was only able to score an effectiveness rate between 70 percent and 80 percent among the 4,000 men who volunteered to take part in the study.

Moreover, in the wake of six recent deaths linked to Viagra, the manufacturer has reiterated earlier warnings related to its use, cautioning that those taking nitroglycerine or other nitrates should refrain from using Viagra. Unfortunately, this automatically disqualifies a large potential user segment, as erectile dysfunction or impotence is a condition commonly associated with some forms of cardiovascular illness.

Second, the insurance companies aren't exactly sure if they're going to reimburse patients for the $10-a-pop pill, even if Kmart and Wal-Mart customers can get a better deal at slightly less than $7.99 and $7.80 apiece, respectively.

As this issue went to press, Oxford had been named in a class-action suit over its decision not to cover Viagra. Meanwhile, Aetna U.S. Healthcare, Prudential Insurance and Kaiser Permanente have stated that until they devise long-term strategies for reimbursement, they won't cover the drug either. Taking a slightly different variation on the "wait-and-see" approach, Cigna Healthcare has set a limit for the time being on the number of dosages for which it will repay its plan members. Until it sets long-term reimbursement guidelines, the company will only pay for six pills per month.

And, last, in the age of self care, it should come as little surprise that only 10 percent of men suffering from impotence ever consult a doctor on the matter (see box on this page). As such, it seems a fair assumption that if given the choice, a large number of impotent men might opt for an OTC remedy as a way to keep their condition to themselves. Especially since the only other opt ions are highly invasive implant surgery, and rather intimidating prescription injection and urethral suppository therapies--all of which are extremely expensive alternatives, to say the least.

Birth of a new front-end category?

But, in order for retailers to cash in on front-end opportunities in erectile dysfunction, it's safe to say there would have to be a category, or, at the very least, a handful of products available for sale over-the-counter that would offer some remedy for the condition.

Since the initial news of Viagra hit, the Food and Drug Administration has approved several vacuum constriction devices for sale as over-the-counter medical devices. Once only available through back-page ads in low-brow "gentlemen's 's magazines" and seedy. edge-of-town sex shops, these regulated versions-as well as several other items hat had previously only been merchandised through such underground channels-are quite likely to plant the seeds for an entirely new front-end category.

The pumps induce erection by utilizing negative pressure chambers to physically draw blood into the penis. Reusable constriction rings are then used o keep the blood in place to mechanically create an erection," noted American Medtech resident George Fettig, Those company is currently positioning itself to be at the forefront of this rapidly emerging OTC intimacy category.

American Medtech is among the early pioneers of the category. About a year ago, the St. Paul, Minn.-based SEE SIGNS ON PAGE CP57 manufacturer unveiled the Rejoyn penile support sleeve, which allows otherwise impotent users to engage in intercourse without first having to achieve an erection.

The company has since been among the first to market with its own OTC vacuum device. Marketed under the Rejoyn label, the Rejoyn Vacuum Therapy taps into the suction technology of the Pos-T-Vac MVP-700 system, which last year was rated the No. 1 prescription pump device of its kind by Men's Confidential (a monthly newsletter published by Rodale Press, publishers of several consumer health magazines, including Men's Health) for high-quality construction and ease of operation. Earlier this year, American Medtech secured the international and national OTC marketing rights to the Pos-T-Vac system. Like the penile sleeve system that preceded it, the newest addition to the Rejoyn line is designed for those who cannot, on their own, achieve a full or even partial erection.