WEB DRAWS CLIENTS FOR DOCTOR BUT CONCERNS IMPOTENCE PILL MAKER

Public demand for Viagra overwhelms Tosa center that advertises on Internet

A Wauwatosa physician has issued more than 600 prescriptions for Viagra,
the new pill for impotence -- more than 300 Monday alone -- after setting
up a Web site to solicit patients.

Michael Thomas, director of the Vascular Center for Men, at 9900 W. Blue
Mound Road, had so many calls on Monday for the drug, he had to delegate to
his office staff the job of medically screening the callers and deciding
whether they should get prescriptions.

"We have three lines and some people said they had been trying to get in
for two hours," Thomas said. At times, the calls came so fast -- 500 per
hour -- that his staff could not answer them. The calls were forwarded to
an answering service, which became so overwhelmed, callers merely got a
message to call back.

But officials at Pfizer Inc., which manufactures Viagra, were aghast at
Thomas' actions.

"Viagra is indicated for the treatment of male erectile dysfunction and it
needs to be diagnosed by a physician in person," said Mariann Caprino, of
Pfizer. "We are opposed to Internet prescribing of any medication."

A spokeswoman for the state Medical Examining Board said it is not illegal,
or considered unprofessional, for a licensed physician to delegate
authority to assistants, as long as they are under the physician's
supervision. The physician ultimately is responsible for any problems that
may occur.

"A physician can delegate to anybody any responsibility for which they are
licensed," she said.

It also is legal for pharmacists to fill prescriptions written by a
physician licensed in another state, although they are not required to do
so, she said.

The surge in calls Monday came after a Wall Street Journal article
mentioned Thomas and his Web site, which he established in April, even
before Viagra went on sale.

Doctors and drug industry analysts expect Viagra to eclipse competing
impotence treatments within months.

According to IMS America, a research firm, Viagra grabbed 5% of the market
during its first week of sales. The Wall Street Journal reported that
prescription sales may be as high as 40,000 a day.

Thomas, a doctor of osteopathy, has run the center -- which specializes in
impotence -- since 1995, he said. He might hire more staff to meet the
demand for Viagra.

"We were actually prescribing it before it was in the pharmacy," Thomas
said. "They just had to wait for it to arrive . . . They wanted to be the
first to get it filled."

The Web site also describes Viagra as leading to "better sexual performance
. . and more enjoyment!" According to the Web site, the center, once it
issues a prescription, will refer clients to a pharmacy that has the drug
"and can ship today!"

Thomas said he asks only that the caller be age 18 or older, male and not
be taking any nitroglycerine-type drugs. A phone screening takes about five
minutes. He charges $50 for consultation and the written prescription of 10
to 30 pills in the 100-milligram dose. A request for a refill prescription
costs $25. The cost does not include pills.

In Milwaukee, Viagra costs $8 to $12 for a 50-milligram pill -- a typical
dose. The pill comes in 25- and 100-milligram sizes as well. In other
cities, pills are selling for $13 or $15.

Thomas advises clients to spend a few dollars for a pill cutter to cut the
pills in half. If they get the desired response with a 50-milligram pill,
they essentially have twice the pills for the same money.

Ironically, Thomas said he hasn't found time yet to get a physician to
prescribe the medication for him. During an interview, he disclosed that he
has been impotent at times.

Asked whether the ease with which he is offering prescriptions might
contribute to a black market for the drug -- pill holders selling pills to
others at inflated prices -- Thomas said the contrary.

"By making it so easy to get, I am actually working to decrease" the
potential for a black market, he said. "It is always possible that people
will resell medications, but I am slowing down that process."

Pfizer recommends that the pill be taken an hour before anticipated
intimate sexual activity. It has emphasized that Viagra is not an
aphrodisiac -- it does not produce sexual arousal.

As for Thomas' claims on his Web site -- www.penispill.com -- of increasing
sexual performance and making sex more enjoyable, "we are absolutely not
making those claims," Caprino said.

The Web site includes a graphic photo and description of the drug's effects.

Before Viagra became available, impotence treatment involved an injection
or devices. Viagra works by increasing nerve signals, which change
biological factors and help maintain an erection. Its side effects include
flushing, dizziness, headaches; and at higher doses, a temporary form of
color blindness.

The Associated Press contributed to this report.