Viagra: The Happiest of All Happy Accidents?

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Did you know that the discovery of Pfizer’s erectile-dysfunction drug Viagra was an accident? While testing a drug that expanded blood cells in the chest to relieve chest pain back in 1991, some patients reported getting erections as a side effect — enough of them that clinical researcher Ian Osterloh decided that this intriguing result merited more study, despite opposition from Pfizer’s staunchly conservative upper management, legislators, the medical establishment, and even the Catholic Church.

As David Kushner reports at Esquire, after getting approval from the FDA, the team wooed urologists to get the little blue pill into the hands of men the world over, making Pfizer a potent profit along the way.

In fact, it’s a miracle that it ever came to be at all. In addition to the people within Pfizer who were in an uproar over the “dick pill,” four major groups began rallying against it before its launch: the Catholic church (which thought it was immoral), medical experts (who insisted patients would be too embarrassed to ask for the pill), business execs (who thought it would make Pfizer a laughingstock), and legislators (who lobbied against the pill for the same reason as the church).

It was the job of two unlikely guys at Pfizer to overcome them all: Rooney Nelson, a young Jamaican marketing whiz, and Sal “Dr. Sal” Giorgianni, a crusty Italian pharmacist from Queens who became Viagra’s medical expert. Together, Nelson and Dr. Sal became the dynamic duo of erectile dysfunction, wooing angry religious leaders, skittish politicians, and cynical pharma nerds from all over.

To sell an erection drug, however, meant swaying the doctors who were way lower down the pecking order: the urologists. Compared with brain surgeons and cardiologists, urologists were the Dunder Mifflin of the pharma world: nerdy, unsexy, and unaccustomed to the warm fuzz of marketing crews. But that was about to change.

The mid-nineties were the heyday for pharmaceutical junkets, but Viagra marked the first time that unglamorous urologists were the ones being seduced. Pfizer would fly a dozen of them to an all-expenses-paid weekend at the Breakers in Palm Beach, Florida, and give them $2,500 each for their time. Pfizer could easily spend $200,000 per trip to entice them. “Urologists, they had never really been to places like that; they had never eaten like that; they had never drank like that,” Nelson says. “So you had a really primed group that was receptive to hearing your message.”

Over dirty martinis and lollipop lamb chops, Nelson would look out into the room and wonder how he was going to energize them. He pitched them on how he was going to make them as cool and desirable as open-heart surgeons. “This is an opportunity for you to be at the cutting edge of what could be the most revolutionary product in a long time in medicine,” he said. But there was one problem, they quickly told him: They never talked about sex with their patients. There was no reason to discuss impotence, because they had no remedy. “No physician asks about things that they can’t treat,” as Nelson puts it. “It was a wall of silence.”

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