Laugh lines

The e-Alert is not a comedy club and I’m definitely not a stand-up comedian, but you’re going to think I’m joking when you hear the latest howlers about the drug company study, the distinguished professor, and the online pharmacy.

As always, I’m not making any of this up. But sometimes I wish I were when I see how ridiculous mainstream health care can be.

Guy walks into a randomized controlled trial

The New Mexico School of Medicine in Albuquerque, and the prestigious Journal of the American Medical Association recently teamed up earlier this month to deliver a not so prestigious study that amounts to little more than an advertising sales pitch.

The authors of the study tell us that male sexual dysfunction is a common adverse effect of antidepressants. As a result, a patient will often stop using his medication in order to get his sex life back on track. But then he’s not spending any money on antidepressants! The drug companies can’t stand for that! He might resort to some crazy “fad” treatment like a combination of exercise, diet modification and counseling.

So Pfizer, the maker of Viagra, funded this New Mexico study, hoping, no doubt, to demonstrate how a depressed male taking Prozac can revive his sex life by taking Viagra. And guess what? Eureka! It worked! Recruiting 90 subjects (all using Prozac, all experiencing sexual dysfunction), forty-five men took Viagra for six weeks, forty-five took placebo, and in the Viagra group a little over half of the men reported their dysfunction to be functioning again.

Believe me, I’m not joking about depression and sexual dysfunction – both are serious concerns for anyone who has to endure them. But the idea of addressing a single side effect of a drug that has many side effects, by taking another drug with its own list of unpleasant side effects, is laughable. Once a doctor starts piling on additional prescriptions to treat individual side effects, you can imagine a patient staring at a medicine cabinet filled with pill bottles, unable to recall what the original health problem was that the drugs were intended to address in the first place.

Waitit gets better

Imagine how much more Viagra Pfizer could sell if they convinced men that they needed to take Viagra every day to prevent impotency. Of course, selling at $10 or more per tablet (as Viagra does), that would get a little pricey. So what if they suggested taking only a quarter of a tab per day? Think men would buy it then? We may get a chance to find out.

Last month, Pfizer was the primary sponsor of a large continuing medical education event in New York. During a panel session on sexual function, Professor Irwin Goldstein (described by the British Medical Journal (BMJ) as a “high profile professor of urology”) called Viagra a “miracle drug,” and said that it should be taken on a daily basis to prevent impotence. The Professor cited a study showing that a quarter of a pill taken each night will successfully address erectile dysfunction.

But the Italian study that Dr. Goldstein used to base his support of Viagra as an impotence preventive involved only 30 men, lasted exactly three nights, and almost a third of the men experienced no benefits. Furthermore, the authors of the study recognized their findings as “preliminary” only. No doubt this is part of the reason why one sex researcher at the session called Dr. Goldstein’s endorsement, “quite scary,” while Dr. Leonore Tiefer of New York University (identified as a critic of corporate sponsorship of educational events) got more to the point, saying the comments were “bordering on the preposterous.”

Meanwhile, BMJ hit the nail on the head, asking Dr. Goldstein if he had ties to Pfizer, to which the doctor replied, “I consult with and lecture for virtually all the pharmaceutical and implant manufacturers.”

Say no more, doc. We get the idea.

It would seem that Dr. Goldstein’s reputation among his colleagues may be less than golden. Nevertheless, the reps at Pfizer must be pleased. No matter how preposterous the idea may be, we might have witnessed the groundwork being laid for a Pfizer advertising campaign that will soon tout Viagra as a one-a-day.

The punchline

Last week on the radio I heard another advertisement for a website that sells Viagra and other prescription drugs. And, in case you don’t know, how do you sell prescription drugs without a prescription? Easy. You offer an “online consultation” with a physician. That’s right. Just place your order, fill out a questionnaire, and based on your responses, a certified doctor will determine if you’re eligible to receive the drug you ordered.

All I could think of was that standard disclaimer at the end of the TV commercials: “Only your doctor can know if Drug X is right for you.” Apparently it isn’t just your doctor. An anonymous doctor sitting in a cube reviewing a multiple-choice questionnaire is also “qualified” to determine if a drug is right for you.

When I come across an absurd loophole like this I have to laugh, thinking about the mainstream medical people who call for the strict FDA regulation of herbal and vitamin supplements. Regulations would successfully restrict access and drive up costs, but would they “protect” anyone? Ridiculous. And this sort of web site, with easy access to (as they put it) “FDA Approved Medications,” is just further proof.

I’m not going to tell you the name of this drug pipeline web site because I don’t want to inadvertently send any business their way. But when I logged on to see how it worked and what drugs they carried, I noticed a prominently placed special offer that read, “Free pill splitter with every new Viagra 100mg order.”

Just the thing for those men who are (or will be) convinced they need to take a quarter tablet each and every day. It just gets more and more convenient.

To Your Good Health,

Jenny Thompson
Health Sciences Institute