Viagra's Hothouse

IT WAS A MOMENT OF BREATHTAKING naivete. Staffers at pharmaceutical giant Pfizer had been preparing for years to launch Viagra, the now infamous anti-impotence drug. After years of clinical studies, they knew it would be a blockbuster product, but they didn't realize its cultural ramifications. One day a team member mused: Gee, do you think Leno or Letterman might someday tell a Viagra joke? They mulled the question. Maybe. It could happen. Two months later, they were on a runaway train. Pfizer chairman Bill Steere recalls days when he'd fall asleep to Leno's Viagra jokes, wake up to Imus's and come home to his wife's latest yucks. Six months later he still seems shellshocked. ""Nobody used to talk about impotence,'' says Steere. ""Now [people] come up to me and tell me about their Viagra moments. I can't believe the things people say.''

Imagine being the manager of the Beatles in 1964, walking down the airplane ramp during their first trip to America--and into all-out pandemonium. That's what this year has been like for Team Viagra, the 60-odd staffers charged with moving the drug from Pfizer labs to consumers' night stands. Since its April launch, Viagra has become the fastest-selling drug in history. But behind the avalanche of headlines lie the staffers whose lives have been consumed by the project. Team leader David Brinkley, a 41-year-old Pfizer veteran who helped in licensing Lipitor, Pfizer's cholesterol drug, has spent the last four years preparing to bring Viagra to market. Even as the hype fades there are dozens of issues for him to deal with, from explaining why 130 people have died while on Viagra to why sales have fallen so sharply. The result: he can't remember the last time he ate a weekday meal outside Pfizer headquarters. For Brinkley and his colleagues, the publicity was a mixed blessing: it brought huge brand awareness--Viagra is now almost as recognized as Coca-Cola--but the jokes hampered the team's ability to drive home its message that impotence (clinical term: erectile dysfunction) is a serious medical malady. Otherwise, they risked insurers' refusing to cover it, and the company's reputation for probity. The early hype also inflated investors' hopes, creating heartburn when sales returned to earth. But as the national giggling quiets down and Viagra becomes just another drug, there are few regrets. ""I would not have traded the experience of working on Viagra for anything in the world,'' Brinkley says.

For Pfizer, Viagra has been a boon to the bottom line and a big test for the corporate culture. Even within the stodgy drug business, Pfizer has a reputation for being starchy and ultraconservative. Jackets stay on during meetings; one hallway is lined with pictures of geezerish Pfizer chairmen dating from 1849. Team members describe a desensitization process, as the red faces of the first meeting (""I can't believe she just said "erection' 14 times'') faded to clinical detachment. The only remaining squirms come when staffers talk with their children about their work. Kids under 10 have a vague awareness that Dad's job involves a drug for men, executives say; teenagers know all the details.

Viagra is old news to Pfizer scientists, who toiled on it for more than a decade. But for Brinkley's team, the real crush of work began on March 27 at 10:37 a.m., when the Food and Drug Administration's approval for Viagra scrolled through their war-room fax machine. The weeks that followed were a blur of windowless conference rooms and Mr. Teng's Chinese takeout, as day and night blended and the only signifier of weekends was the need to remind custodians to keep the ventilation system running. From its prelaunch planning, the team knew Viagra created unusual challenges. Rounding up focus-group volunteers to develop marketing for an allergy medication takes a week; for each of Viagra's scores of focus groups, finding men willing to talk about their limp penises could take a month. Consider another usually simple issue: how many pills to put in a package? For most meds, it's a no-brainer; with Viagra, says market researcher Janice Lipsky, it could send messages about what's a ""normal'' sex life. Their solution: leave quantities up to doctors.

Long before the launch, the team pondered Viagra's potential societal implications. They hired prominent University of Pennsylvania bioethicist Arthur Caplan to pepper them with hypotheticals. How will Pfizer respond when a rapist uses Viagra? (It's out of Pfizer's control, they say.) What if nursing homes complain about requiring more private rooms to facilitate patient romance? Should Alzheimer's patients receive the drug? In the wake of Viagra- mania, apocryphal tales arose. No, Pfizer didn't ask the Vatican to bless the new drug, though staffers did meet with papal science advisers to explain that it's not an aphrodisiac. No, the name ""Viagra'' wasn't chosen because it connotes the unyielding power of Niagara Falls. The name was drawn randomly from a database of potential names; in fact, the diamond-shaped blue pill that launched a billion erection jokes was almost called ""Alond.''

For a drug that's all about sex, the team's most grueling work is extremely unsexy. Typical was last Thursday's meeting, in which five staffers--a lawyer, doctor, pharmacist, psychologist and marketer--were nit-picking over a brochure explaining why HMOs should pay for Viagra. Can they really call erectile dysfunction a ""serious'' condition, or is ""significant'' fairer? (""Significant'' wins out.) Should the Viagra logo be on every page, or is that too hucksterish? (Tone down the branding, they decide.) Can we increase this type size to conform with FDA guidelines? The work of this Review Committee, which combs over every training manual, sample box and advertisement, is mind-numbing but critical: one misstep could misinform patients, add fuel to lawsuits or lead the FDA to recall the materials. ""It all hinges on a word or a nuance or a phrasing,'' says team leader Brinkley.