Nancy Bacher Long, director of PR at Dorland Sweeney Jones Health Communications, in Philadelphia, says that if she were handling communications for a new erectile dysfunction remedy, she'd borrow from Pfizer's own pre-launch PR for Viagra. But she would give it a guerrilla twist, aiming her promotion at segments of the population Pfizer might have overlooked, such as particular ethnic or age groups, or people already taking certain medications. Companies can't promote specific drugs before they are FDA-approved, but Bacher Long says they can do 'category promotion' - that is, interest reporters and editors in covering the larger medical issue as a way of keeping it in front of consumers.

Joe Torre, CEO of Torre Lazur McCann Worldwide Communications, in Parsippany, NJ, says the key to carving a market niche for a new drug is highlighting any advantage over the established players, whether it be price, safety, time of response or anything else. 'No matter how slight, you exploit it to the hilt,' Torre says.

What if there is no particular advantage? No problem, he says. Break out the emotional branding, much like MasterCard's 'priceless' ad campaign, which gets people all fuzzy over a product that's no different from anyone else's.

One ED drug that might need such lifestyle branding if it reaches the market is Vasomax. Once considered a front runner in the field after Viagra, Vasomax, developed by Texas-based Zonagen but licensed to New Jersey-based Schering-Plough, has skidded badly on the road to approval. The FDA wants two more years of tests because some of the animals given the drug developed an unusual kind of fat. Schering-Plough already markets Vasomax in Mexico and Brazil but has kept a low profile, says Zonagen spokesman F. Scott Reding, especially in Brazil, where some have questioned why the drug remains unapproved in its home country.

Zonagen president and CEO Joseph Podolski says public relations will play a significant role 'when and if we ever get to launch Vasomax.' He says Schering-Plough will position the drug as one that permits an active sex life without heart risks or fickle side effects. Schering is experienced at coming late to the fight. 'Look at what they've done with Claritin,' Podolski says. 'It certainly wasn't the first antihistamine out there, but through good PR and direct-to-consumer advertising they've positioned themselves as number one in the world.'

Germany's Bayer AG is testing an ED pill and hopes to apply for FDA approval in 2001. Mary Sawyers, media rep at Bayer's pharmaceuticals division in Connecticut, says worldwide PR duties have been assigned to Fleishman-Hillard, and the companies are 'carefully' planning a communications strategy.

Fleishman SVP Anne St. Peter says her firm will be charged with, among other things, making sure Bayer's entry into the ED field is viewed as serious medicine for a health condition and not some lifestyle-enhancing elixir. 'Frankly, I think that's something Bayer is concerned about,' says St. Peter. 'They want the focus to be on the medical need.'

One group that could be hurt by a proliferation of prescription ED drugs is natural supplements, including herbal remedies, which have been hyped for sexual potency through everything from traditional advertising to sex-oriented chat rooms. No drug makers contacted for this article consider herbals a threat to their business, and doctors point out that none has been clinically proved to correct erectile dysfunction.

Jim Kinsinger, quality assurance laboratory director at Celestial Seasonings, in Boulder, CO, which sells various herbal blends, says 'more reputable firms' don't promote herbal concoctions for erectile dysfunction or sexual stamina. He says his company markets ginseng products for energy.

'What you're using that energy for,' he says, 'is up to you.'

At The Pain & Stress Center, a San Antonio, TX clinic, Dr. Billie Sahley says patients have successfully taken arginine, a human amino acid in capsule form, to overcome erectile dysfunction. In some cases, says Dr. Sahley, patients turned to arginine because they couldn't afford the pricey Viagra.

'One couple was on it,' she recalls' but they can't buy groceries if they continue to buy Viagra.'

Pfizer's McCormick says his company had to pursue legal action against some herbal knock-offs of Viagra and counter reams of Internet-centered scuttlebutt and misinformation that 'you normally don't deal with on a pharmaceutical product introduction.' He says Pfizer views Viagra's impending competition as a good thing 'in the sense that there will be more companies, physicians and others in the healthcare community talking about erectile dysfunction. We'll view the press interest in competing medicines as another way of getting the word out on Viagra.'

Whether that will give Pfizer a boost to the bottom line remains to be seen. McCormick says Viagra's PR won't change very much. It will depend a lot on publicizing results of ongoing Viagra trials with different ethnic groups, patients with various medical conditions and women (for female sexual dysfunction). Viagra, McCormick promises, has staked out its turf in the erectile dysfunction arena 'for decades to come.'