New Viagra site won’t end male embarrassment

 

Want Viagra without the inconvenience and potential embarrassment of the pharmacy line?

Pfizer Inc., the drug’s producer, now has a site for you: its own Viagra.com, where you can get the blockbuster impotence fighter without wondering what shady source you’re dealing with. Using CVS Caremark Corp. to verify prescriptions and fulfill orders, the site is Pfizer’s latest attempt to fight counterfeiting.

In its announcement this week, the world’s largest drug maker cited a 2011 analysis it did of pills bought from 22 sites ranking high in search results for “buy Viagra.” About 80 percent were fake, containing only 30 percent to 50 percent of the drug’s active ingredient, sildenafil citrate.

The new site is a reminder of the original value of consumer branding: as a guarantee of quality. It’s also evidence of the failure — and the perverse effects — of online drug regulation.

In an era when trendy products sell themselves with packaging and ingredients reminiscent of patent medicines, and “branding” usually implies the value created by meaning and associations, we tend to forget the original appeal of large, impersonal consumer brands. In the late 19th century, Gold Medal Flour and Uneeda Biscuits didn’t sell consumers a lifestyle. They promised to deliver safe, fresh food. Ivory Soap touted purity to counteract fears of tainted products from unknown sources.

For the first century of consumer brands, most consumers weren’t looking for quirky and interesting. They were looking for reliable. “The best surprise,” was, as Holiday Inn put it in the 1970s, “no surprise.”

Nowadays, we tend to take basic quality for granted and look for other value in the brands we choose — all the more so when we assume we’re buying a heavily regulated product. Pfizer’s site reminds drug buyers to look for a label that guarantees what they’re getting.

The new site is a worthy attempt, but it faces two big problems.

The first is that the very success of Viagra as an impotence drug that actually works has lent credibility to claims most men used to greet with skepticism. Before Viagra’s 1998 introduction, if a concoction claimed to cure impotence, only the truly desperate or gullible would try it.

Not so today. Among the drug’s unexpected side effects, then, has been a spate of latter-day patent medicines claiming to offer “natural male enhancement.” These aren’t counterfeits per se. They’re alternatives whose “natural” formulations — if true — generally put them outside federal drug regulations. Pfizer’s new site doesn’t directly address that competition.

The second, more significant problem is that the site does nothing to confront what’s really driving people to websites peddling counterfeit drugs: the prescription system.

In its news release, Pfizer cited a study by the National Association of Boards of Pharmacy that found a mere 3 percent of online pharmacies were operating in compliance “with state and federal laws and/or NABP patient safety and pharmacy practice standards,” including the requirement for a “valid prescription.” Almost two-thirds of the questionable sites post no physical address, either in the United States or abroad, and 39 percent don’t have a public domain name registration making them easily trackable. (Neither, I should note, do my own personal websites.)

This result wasn’t inevitable.

In the early days of the Internet, established brick-and- mortar pharmacies set up online shops selling “lifestyle” prescription drugs, including Viagra, Roche Holding’s weight- loss drug Xenical and Merck & Co.’s anti-baldness drug Propecia. It was a good way for independents to make money in competition with the big chains.

I visited one such pharmacy in early 2000, a small shop called the Pill Box in San Antonio. Founded in 1971, it started selling drugs online in January 1999 and a year later was doing a big business, with online sales then making up half of revenue. (The rest was medical equipment and compounded drugs.) The boom was driven primarily by Viagra.

“I don’t think it would have ever occurred if it had not been for the drug Viagra,” Pill Box owner Bill Stalknecht, a licensed pharmacist, told me. “There is so much untreated erectile dysfunction, so much that guys won’t ever talk about. They’ll talk about it on the telephone, but they will not see a doctor.”

It didn’t take long for state regulators to drive such operations off the Internet. Although the legitimate pharmacies started out taking faxes of patients’ prescriptions, the big expansion came when the Pill Box and others hired physicians to review online questionnaires and prescribe drugs without actually meeting their patients — a big no-no. Regulators balked, and state authorities began going after the doctors and pharmacies.

The result was today’s Viagra underground.

If you’re going to take Viagra, you would be wise to see a physician first. But a lot of patients are still determined not to. Maybe they’re too embarrassed, or maybe they think they just can’t spare the time. So instead of taking the risk of an online questionnaire in lieu of an exam, they take the larger risk of buying drugs with unknown formulations from sources with uncertain identities. If something goes wrong, no one can be held responsible.

Pfizer’s new site will undoubtedly pick up a few patients who search “buy viagra online” and just want to renew their prescriptions. But aside from search engine results, it offers little you can’t already get from CVS.com. As long as a real bottle of Viagra requires a visit to the doctor, even the most clearly branded site won’t do much against counterfeiters.

Virginia Postrel is a Bloomberg View columnist. She is the author of “The Future and Its Enemies,” “The Substance of Style” and the forthcoming “The Power of Glamour.”

© 2013, Bloomberg News

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