Erectile dysfunction patients need not resign themselves to a decline in their sex life. With Viagra, they have an effective, well-tolerated, and convenient treatment alternative.

While Pfizer’s pharmaceutical business in the 1990s has been very successful, 1997 was a year of particularly excellent achievement. The Company’s relatively young portfolio of products showed continued growth. In addition, Pfizer, together with copromotion partners, launched two major new drugs that produced more than one billion dollars in combined worldwide sales and generated revenue to Pfizer of $316 million for its marketing investment. The launch of one of these two products—the cholesterol-lowering agent Lipitor, which was discovered and developed by the Parke-Davis Research Division of Warner-Lambert Company—was one of the most successful U.S. introductions ever of any pharmaceutical in any therapeutic category. The other product—Aricept, discovered and developed by Eisai Co., Ltd.—became the leading U.S. drug for symptoms of Alzheimer’s disease within a month of launch.
These two launches bring to 10 the number of major new pharmaceuticals launched by Pfizer in the past decade. In 1997, Norvasc became the Company’s first $2 billion product, and Zoloft’s sales exceeded $1.5 billion. Three other products—Zithromax, Diflucan, and Procardia XL—each had sales in excess of $800 million. Combined revenue from our 10 newest products grew 18 percent in 1997, to more than $7.6 billion, and now represent 83 percent of Pfizer’s total pharmaceutical revenues.
Pfizer also submitted broad regulatory filings for three major new Pfizer-developed products—Trovan, Viagra, and Zeldox. Trovan, which has been approved by the U.S. Food and Drug Administration (FDA), has the potential to become the antibiotic of choice for a broad range of infections. Viagra offers simple, well-tolerated therapy for a medical condition that is both widespread and poorly served—erectile dysfunction (ED), or impotence. And Zeldox, for the treatment of schizophrenia, provides important long-term therapeutic benefits for psychotic patients.

HEALTH CARE % Change (millions of dollars) 1997 1996 1995 97/96 96/95 Revenues Pharmaceuticals Medical Technology $  9,239 1,450 $8,188 1,442 $7,072 1,337 +13 +  1 +16 +  8 Health Care Revenues $10,689 $9,630 $8,409 +11 +15 Segment Profit $  3,309 $3,090 $2,548 +  7 +21

Pfizer’s pharmaceutical revenues have increased faster than the global pharmaceutical market during every year of the 1990s. On average, over the past five years, Pfizer’s sales have grown at about twice the industry rate. As a result, despite several large mergers and acquisitions by competing companies, Pfizer has moved from its position as the 13th-largest pharmaceutical company in worldwide sales six years ago to the 4th-largest today.
Pfizer is a pacesetter in today’s global pharmaceutical industry. We are preparing the worldwide launch of several major new products while strong patent protection remains for our growing and relatively young currently marketed product portfolio. Pfizer is preparing for these launches with a worldwide field force of 14,500 people, nearly 50 percent larger than just three years ago. Pfizer’s U.S. sales force was recently rated the highest-quality group in the industry for the third straight year in a Scott-Levin survey of physicians. By working to ensure a consistent stream of major new products, Pfizer’s vision and mission is to become the world’s premier research-based health care company.
Pfizer’s pharmaceutical product portfolio spans eight therapeutic categories: urogenital disorders, cardiovascular diseases, infectious diseases, central nervous system disorders, diabetes, allergies, arthritis, and women’s health issues.

Urogenital Disorders
The development of one new Pfizer compound sheds light on the length of time involved in new drug discovery and development. In 1985, Pfizer began to synthesize drugs to selectively inhibit phosphodiesterase (PDE) enzymes for various potential therapeutic applications. In the late 1980s, the Company had synthesized a compound that was a strong, selective inhibitor of the subtype 5 of PDE. Our scientists determined that PDE 5 inhibition served to selectively relax smooth muscle tissue in the penis, and thereby could enhance an impotent man’s capacity to achieve an erection. Because oral medication for erectile dysfunction was a new field, years of work were necessary to design clinical trials, establish patient selection criteria, and develop efficacy measures. The completion of these clinical trials eventually bore out the exceptional efficacy of this compound—Viagra—in treating ED.
Of the more than 100 million men worldwide suffering from ED, fewer than 10 percent are currently being treated. Many ED cases are thought to have purely organic causes, relating to conditions such as diabetes, hypertension, and spinal cord injuries; a smaller number are psychogenic in origin; and the majority of cases have mixed causes. Viagra has been shown to work in all types of patients studied, although efficacy rates vary somewhat, based on underlying etiology. Viagra has been extensively studied in 20 clinical trials with more than 3,500 patients worldwide. In these trials, 78 percent of Viagra patients reported improvement in erections as compared to only 20 percent of patients on placebo. The median time to onset for fasted Viagra patients who obtained erections sufficient for sexual intercourse was 25 minutes. Discontinuation rates due to side effects were similar to placebo. Unlike other therapies for ED, Viagra has the convenience of an oral medication. Viagra was filed in late September 1997 with both the FDA, where it is receiving a priority review, and with the European regulatory authority; regulatory filings in other parts of the world have followed.
Viagra will complement Pfizer’s current urology business, which includes Cardura, a medicine that treats elevated blood pressure and benign prostatic hyperplasia (BPH), the noncancerous growth of the prostate gland, and the subsidiary American Medical Systems, the world’s leading manufacturer of impotence and incontinence implants (see Medical Technology Group).

“Erectile dysfunction (ED), often called impotence, is a common medical condition affecting more than 100 million men around the world—and their partners. About 80 percent of cases are caused by medical, not psychological conditions; and many urologists believe that ED can be a marker for underlying conditions such as diabetes and certain cardiovascular diseases. Although more than 95 percent of men who have ED can be treated effectively, fewer than 10 percent seek treatment, either because of misconceptions about treatment options or because they are too embarrassed to do so.

Dr. Eid, right, consults with a Viagra patient and his wife at Cornell Medical Center in New York.