The Vascular Center for Men: The Internet Incident

THE INTERNET INCIDENT

Dr. Michael Thomas, Director of the Vascular Center for Men in Wauwatosa, Wisconsin, decided to set up a Web site in late March, 1998, to solicit patients for the new impotence pill, Viagra™ (made by Pfizer, Inc.). The Food and Drug Administration approved Viagra™ in late March for prescription distribution.  Second quarter sales were $400 million, while third quarter sales were $141 million.1  Some physicians and pharmacists across the United States, like pharmacists Ron Grove of Warsaw, Missouri, and William Stallknecht of San Antonio, Texas, have established similar Web sites since April, 1998.

Dr. Thomas, an osteopath, subsequently issued more than 600 prescriptions for the pill.  On Monday, April 20^th, alone, his office was bombarded by telephone calls, up to 500 calls per hour.  That day he wrote out more than 300 prescriptions.  The reason for the notoriety of his Web site was the fact that it had been mentioned in a recent Wall Street Journal article.

The drug was described on Thomas’ Web site, penispill.com2, as leading to better sexual performance and more enjoyment.  The site also stated that the Vascular Center would refer clients to pharmacies that had the drug, once prescriptions were issued, so that the drug could be shipped out immediately to the buyers.

Callers had to be 18 years of age or older, male, and not be taking any type of nitroglycerine-based drugs.  Office assistants screened the callers over the phone.  Dr. Thomas was able to talk to some of those who had called, but not all.  He charged $50 for each consultation and a prescription for 10 to 30 pills (100-milligram dosage).  To obtain a refill prescription, the caller must pay Dr. Thomas another $25, as well as pay for the pills separately.

Pfizer officials were not pleased with Dr. Thomas’ efforts and are basically opposed to the prescribing of any medication via the Internet.  Further testing of Viagra™ has revealed some dangerous problems with the drug when taken with certain other medications, such as nitroglycerin, or if the patient has a history of high blood pressure or heart disease.  The Wisconsin Medical Examining Board was initially unaware of the incident until questioned by the media.  Most state boards consider online prescriptions to be bad medical practice, but have not developed laws regulating such prescriptions.