- The Washington Times - Monday, March 3, 2003

NEW YORK (AP) The success of Viagra has companies racing to achieve a female equivalent, and one herbal product's claims of effectiveness are stirring debate on whether any one drug can be the answer for women.
"They have Viagra. Now we have Avlimil," its makers boast in magazine and television advertisements.
As an herbal treatment, Avlimil didn't require the extensive study and tests necessary for U.S. Food and Drug Administration approval. But that does not prevent it and others like it from promoting themselves as giving women what Viagra offers men.
Since the 1998 introduction of Viagra, which racked up $1.7 billion in sales last year for New York-based Pfizer Inc. as a treatment for male sexual dysfunction, at least 10 pharmaceutical companies have undertaken development of a similar drug for women, says market-research firm Decision Resources.
Their efforts were spurred on by a 1999 study that said 43 percent of women had difficulties with sex. Decision Resources estimates the global market for an effective treatment at $2.7 billion to $3.2 billion by 2006.
Avlimil's splashy promotion has helped intensify debate over how to help women with sexual problems, as has a January article in the British Medical Journal that accuses drug companies of exaggerating female sexual dysfunction to peddle medicine.
No one questions that many women have difficulties with libido, arousal and orgasm. But because women's sexuality is more complicated than that of men, many question how key any drug would be to treatment.
"For women, arousal and desire starts in the brain. Women's sexual dysfunction often has a psychological component," says Dr. Adelaide Nardone, a gynecologist and obstetrician who is also a consultant to Vagisil, a line of women's health products.
Dr. Nardone said drugs may help women whose sexual difficulties are tied to physical conditions. But because the conditions are diverse, it is unlikely one drug will help all women.
Avlimil claims it can help in all types of sexual problems. The assertion is based on a company-sponsored, three-month trial of 49 women. Trials for prescription drugs usually take years and often include thousands of patients.
Since Avlimil's introduction two months ago, 30,000 people have purchased it, said Susan Cossman, vice president of marketing of Warner Health Care, a division of Wagner Pharmaceuticals. A month's supply of the pills costs $49.25.
Avlimil sales are expected to hit $110 million in 12 months, Miss Cossman said.
Wagner is spending $3 million to $5 million on ads in magazines such as Health and Ladies Home Journal and women-oriented cable television stations such as Lifetime.
The polished campaign, which says that 50 million American women suffer from sexual dysfunction, sets Avlimil apart from scores of other herbal remedies, many sold on the Internet, that have less-visible but often steamier marketing approaches.
"It is intentional for us to use quality in the ads because we want women to look seriously at the issue of sexual dysfunction," said Miss Cossman.
Not everyone is buying the marketing.
"Just what we need more ads that try to appeal to a woman's fear that she isn't normal," said Dr. Leonore Tiefer, an associate professor of psychiatry at the New York University School of Medicine. "Fifty million is a ludicrous number. There may be 50 million women dissatisfied with their sex lives, but it is probably for 50 million different reasons."
Miss Cossman says the 50 million figure was derived from the 1999 study in the Journal of the American Medical Association, which said 43 percent of women experience sexual dysfunction. Now even some in the drug industry believe the article overstates the problem.

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