Shunning any temptation to promote Viagra as a slam-dunk aphrodisiac, Pfizer and PR counsel Ruder Finn and Chandler Chicco portrayed the drug in strictly clinical and scientific terms, and in so doing helped pull ED into the cultural mainstream.

'They have set the trail for us,' says Kim Modory, manager of public affairs at TAP, 'and we need to build upon that.'

TAP has selected BSMG Worldwide, in New York, to handle Uprima's PR, and hopes to sign up well-known spokespeople to discuss erectile dysfunction, much as Pfizer did with Bob Dole. Modory says TAP's media strategy will target women as well as men, because some erectile dysfunction sufferers don't seek treatment unless encouraged by a partner.

'Our communications will be focused very much on direct-to-patient and direct-to-partner education,' she says.

Even the drug's name, Uprima, was conceived as a subtle PR touch, implying 'you, the patient, are first.'

Modory says TAP is planning outreach programs for Uprima aimed at known ED sufferers and age groups in which the condition is most widespread.

Pfizer's biggest promotion for Viagra is its current Winston Cup race car sponsorship, though McCormick hints it might have other publicity projects in the works.

'We want to communicate with men where they are,' he says.

Side effects have dogged Viagra and Uprima and provide fodder for rivals in the ED drug market. Some men on heart medications that lower blood pressure died after taking Viagra, which does the same. During Uprima's testing phase, some patients fainted, vomited or were beset by fits of yawning.

'Talk about memorable evenings,' deadpans Mel Snyder, consultant in charge of business development at MacroChem.

Snyder says his company's product, Topiglan, could be approved in 18 months and will be marketed to internists and general practitioners, whom men consult more readily for erectile dysfunction than they do urologists.

MacroChem president and CEO Alvin Karloff says his company is about to start scouting nationally for financial and PR firms. He likes his product's chances in the marketplace, especially, he says, because oral ED remedies attract only the small fraction of potential users not scared off by the possibility of systemic side effects.

'These other companies, with their orals, are all going to fight for that little segment,' he contends.

Not so fast, says one urologist. Dr. Drogo Montague, director of the Center for Sexual Function at the Cleveland Clinic Urological Institute, says significant roadblocks remain to a topical reaching the market, including the FDA requirement that it be approved for both the user and his partner, and the inability of most topicals to effectively penetrate the skin.

MacroChem has patented an 'enhancer,' called Sepa, that it says solves that problem.

At Vivus, which saw Pfizer snatch its market share like a schoolyard bully taking lunch money, talk of public relations is strategically and financially premature. The company is running its first ad for Muse in a year and a half, in Practical Diabetology. Terry Nida, senior vice president of sales and marketing, says Vivus would like to try to 're-establish the viability of transurethral therapy,' possibly through publicizing the reported effectiveness of a combination of alprostadil and sildenafil, the main ingredients in Muse and Viagra, respectively. Nida says a pickup in sales would motivate the company to more seriously consider a PR campaign.

'If we start seeing growth, we'd like to feed the lion,' he says.