Damien on… The Truth About Sildenafil Citrate
…which, since it involves big corporations and governments, is a saga of greed, incompetence and rank stupidity.
For those who don’t know, sildenafil citrate is the generic name for – a brand name that rhymes with Niagara. But since this historian has no desire to be SUED by a certain company whose name rhymes with None The Wiser, he’ll state right now that the following in no way relates to any real product, event or company. Okay?
This writer first heard about sildenafil citrate, when it was just ending its FDA trials. At that point, it didn’t HAVE a brand name. And since the FDA have to PUBLISH their findings, a friend got him the results off the Interweb (he didn’t have a computer in those days).
Whilst most of the report was technical, one didn’t need to be a rocket scientist to know what “penile tumescence” meant. Your Humble Scribe realised this would be big (so to speak) – and waited for more news.
Over the next few months, it emerged that the price at the factory gates for these wonder-pills would be £4.75 (around $7.50) per pill – REGARDLESS of the SIZE – 25mg, 50mg and 100mg. Huh? What sense did THAT make?
It further emerged that 100mg would be too strong for most people (it’d make their eyes go funny) while 25mg would do little. However 50mg would – like the Third Bear’s Porridge – be just right.
This turned out to be the FIRST cock-up committed by those in charge of the discovery. Oh yes, let’s be clear on THAT. Rhymes with Niagara wasn’t INVENTED – it was stumbled upon by ACCIDENT, when None The Wiser were running clinical trials on what they hoped would be a drug to help sufferers from angina.
It didn’t work, but only when the test subjects proved reluctant to part with the unused pills did None The Wiser realize they might be ON to something!
Anyhay, apparently no-one at None The Wiser CONSIDERED that people MIGHT just think of CUTTING the 100mg sizes of their HIGH-priced wonder-pills in TWO. After a couple of YEARS had passed, they belatedly advised people NOT to – as it would affect the drug’s absorption rate (make it work FASTER – so?)
But by that time, they were far too late. EVERYONE was buying the 100 mg pills and cutting them – either using a sharp knife or a “pill-chopper” (sales of which had by then sky-rocketed). Has anyone ever SEEN a 50 or 25 mg pill?
Cock-up number two was with the MARKETING. Although to be fair to None The Wiser, it wasn’t entirely their fault. The thing is, people STILL think of drugs as being one of only TWO types. Those you take to cure an ILL – and those you score from a guy called Big Louie on a street-corner.
But of course, for some time now, there has been a THIRD category – “lifestyle drugs”. These can make you smarter, faster, hornier or hairier – whatever you need. But since all drugs have MANY effects, some medical supervision is useful (like, hairy-pills make you grow breasts).
And that was the problem for None The Wiser. Since there were few facilities for marketing these drugs, outside of the Interweb, they elected to sell rhymes with Niagara as a MEDICINE (the word appears FREQUENTLY on the patient information leaflet).
Which it really ISN’T. Sildenafil citrate merely reduces the BACK-FLOW of blood FROM the penis, like a cock-ring (which have been around for MILLENNIA – but of course, a pill is a lot less INVASIVE) and will NOT cause blood to flow INTO the penis – and is therefore USELESS as a cure for impotence.
It merely gives you more CONTROL, so that miaowing cat, or noisy party, or sudden realisation that you left your car-keys in the ignition – or any other distraction that causes you to lose your concentration on the job in hand – doesn’t cause you to lose your ERECTION.
So, rhymes with Niagara was just a very useful LIFESTYLE drug. But its discoverers understandably didn’t want their new wonder-drug consigned to the plethora of products available on the Interweb, which claim to make you lose pounds in days – or live forever – or become INVISIBLE.
Thus they went the medical route. But they botched it. In Britain, once this scribbler heard what the pills were going to retail for, he worked out that if the National Health Service issued them on prescription on DEMAND – it would cost them around £4 BILLION a year. A few months later, a newspaper (well – the Daily Mail) did the same sums and belatedly came to the same conclusion.
But there were still several months to go before the pills would be on sale, so both None The Wiser and the British government had plenty of time to work out a sensible solution to the problem. Like, given that the production cost of sildenafil citrate is PENNIES, reduce the price by 40% to the NHS – None The Wiser would STILL have made a PACKET – and then let the NHS issue them one pill per prescription charge. Simple – and the NHS would have made a packet too.
However, this simple answer didn’t occur to EITHER party and the whole business turned into a FIASCO. This reporter had a friendly doctor who gave him prescriptions for FREE – and he then haggled pharmacists down to £7 a pill. So £3.50 a pop, then.
But many others paid ABSURD prices for “consultations” with greedy quacks (three questions and a blood-pressure test – a first year medical student could do it in forty-five seconds) and even MORE absurd prices for the pills themselves.
Eventually “copy-cat” drugs emerged. But their manufacturers followed the precedent established by None The Wiser – called them medicines and issued pills (all sizes the same price) that were still horribly expensive, thus effectively inviting purchasers to continue cutting them.
But today, now that None The Wiser’s patents have run out in many places, LEGITIMATE, professionally-manufactured GENERICS are available. In India, the 100mg sildenafil citrate pills sell for 37 rupees each. About £0.50 (80 cents). That’s 25 PENCE (40 cents) a pop.
In Thailand, yours truly gets ’em (imported from India) from a local pharmacist for £2 ($3) each – or £1 ($1.50) a pop – no prescription required. But back in Blighty and America, people are STILL being ripped off.
And it could all have been SO different. Like with the fatuous and unwinnable War On Drugs, had a little commonsense prevailed, for the last decade, people would have been able to enjoy man’s greatest technical achievement in the field of PHARMACY the way they have those in electronics, engineering and so on – CHEAPLY and FREELY.
Instead of which, the whole enterprise has been besmirched by rip-off corporations and bedevilled by bureaucratic bullshit.
It’ll be the same with genetic research, stem-cell research…
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UPDATE! I wrote the above piece YEARS ago – but it appears little has changed since.
Recently, a bloke in Britain got busted for selling “fake” rhymes with Niagara. Except the pills in question were the Indian ones I spoke of above, which are NOT FAKE – but GENERICS. There is a WORLD of difference.
“Fake” drugs are often manufactured in dismal, unsanitary conditions and contain all SORTS of crap. Whereas generics are PROPERLY and LEGITIMATELY manufactured.
And since the Indian brand name (Kamagra) was specified – I’m surprised the company did not SUE.
I further learn that supermarkets have now joined in the selling of sildenafil citrate pills – playing the role of PHARMACISTS. They do as I described above: ask a few questions and take a blood-pressure test.
But the pills they sell are still rhymes with Niagara – at only slightly less than the original highly inflated price.
So why do they not sell GENERICS? Apparently, it is because they have not been “approved”.
Now, I’m no expert on the laws regarding pharmaceuticals – but surely, if a drug is a GENERIC of a drug that has already been approved, it enjoys the same status. Right?
Only if its quality is below par, should it have a problem – which is the case with ANY generic drug.
Then there is the issue of PRESCRIPTIONS. In Britain, there are four classes of medicinal drugs: the most potent can only be issued in a hospital, while most other drugs can be issued by a pharmacist, on production of a prescription. Then there are SLIGHTLY potent drugs which can be issued off-prescription, but only under the “supervision” of a qualified pharmacist – and finally, “soft” drugs (like cold cures) that can be sold anywhere.
I’m not including “herbal remedies” – which are a whole other thing.
And of course, since sildenafil citrate is not a “controlled” drug (i.e – ILLEGAL) one can always buy them over the Interweb. Which is where the “trafficker” got it wrong. If he had bought the Indian generics and despatched them from ABROAD, he would not have run foul of British law.
However, some of his shipments might have been intercepted in the POST.
Which brings us to a “cloudy issue” – the status of ALL LEGITIMATE imported materials.
I recall that before I escaped Britain, I used to go on an annual pilgrimage to the Algarve, in Portugal – to buy my year’s supply of CIGARETTES.
Since in Britain, cigarettes are taxed at LITERALLY A THOUSAND PERCENT – many people use the 1993 Single European Act to save themselves A GRAND a year, by going abroad to buy them.
In fact, there are MANY items where purchasing them in Europe can save you a packet – like CARS. The only limitation is you cannot resell the item(s). Although with cars, I believe there is a time limit (no-one wants to drive a car for EVER – not even a VOLVO).
However, HMG does not like its citizens avoiding (not EVADING) tax – so harasses them at every opportunity. Like the time they introduced a THIRD Customs “gate” at airports, for those who had purchased items within Europe. An obvious attempt to intimidate those purchasers.
Although, as I understand it, they dumped the idea before it had started.
Nevertheless, as with the status of sildenafil citrate, the procedures for European “personal imports” are VAGUE, to say the least.
Like with fags, you can import up to TEN THOUSAND (the 400 is just a “guideline” – it means you won’t be HASSLED by HM Customs) from within Europe. Which is a reasonable year’s supply. That’s one case, containing fifty cartons – which is five hundred packs. Over the year, around 27 cigarettes a day.
But if you are intercepted by Customs, you are “required to prove they are solely for your own use” – so how the hell do you do THAT?
If challenged, I would have pointed out the fags were FOREIGN – and thus could not be sold “over the counter” in Blighty. Further, that they were all the same brand. And that I was a smoker. And that I had no connection with any form of “distributor”. And that I only did one trip a year (although with no stamps in my passport – Europe doesn’t bother anymore – I would have had no way of proving that).
And finally, that given “black market” ciggies cost LESS than I had PAID for them – it would hardly be worth my time.
I could then have produced a few upstanding British citizens who would have been happy to declare that to the best of their knowledge and belief, I did indeed go on an annual sabbatical to buy my fags – then smoke them, over the year.
This would probably have sufficed – the only way I could have TOTALLY PROVEN my case would have been to have had a Customs officer personally ACCOMPANY and observe me for the year – hopefully, an attractive FEMALE one (if such exists).
Actually, one almost feels SYMPATHY for HM Customs – HMG has made their job IMPOSSIBLE.
Every day, thousands of PLEBS do Channel-crossings to Calais and load up with “cheap” (not so much) booze and fags – there are hypermarkets that specially cater for them. At one point, British cigarette manufacturers used to ship their products over there – so they could be brought straight BACK and resold in Britain.
But then, HMG made them label the packs “UK tax not paid” – thus driving the trade underground.
Plus Customs were given (somewhat fascist) powers to CONFISCATE vehicles that had been used for smuggling (one wonders how THAT little ploy worked out, when said vehicles had been RENTED?)
Then eventually, LEGITIMATE personal importers began REVOLTING and started taking Customs to COURT. Several cases ensued, which Customs usually LOST – at great financial cost and embarrassment to themselves.
Furthermore, an increasing number of travellers began objecting to the harassment they received from Customs – pointing out that every time they returned from a holiday, they were made to feel like criminals, when they were doing nothing WRONG.
They also pointed out that the OTHER citizens of Europe didn’t have to go through this crap every time THEY crossed a border. Indeed, some of Europe’s borders are so “casual” – you can cross one without even NOTICING.
Only in cold, eternally-wet, miserable, over-priced BRITAIN, do people have these problems.
Which is one more reason this boy is GLAD to have escaped the damn country. Here in Thailand, fags are eighty pence a pack, sildenafil citrate costs a pound a pop (no prescription) and even in the Rainy Season – it don’t rain ALL BLOODY DAY.
No wonder Thailand is known as The Land Of Smiles…
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ANOTHER UPDATE! Land Of Smiles indeed. In Britain, the regulatory body for drugs is called the Medicines and Healthcare products Regulatory Agency (MHRA). And it is they who “approve” drugs (see above) which are then listed in the British Pharmacopoeia. Thus, generics generally have the letters “BP” printed after them.
So you can still buy Nurofen and pay for the brand name – or get ibuprofen BP, which is exactly the same, for considerably LESS. This is because ibuprofen long ago went out of copyright and became available for any manufacturer to produce.
But the story with sildenafil citrate is more complicated. Different countries take varying attitudes towards None The Wiser’s patents on rhymes with Niagara.
And in Britain, while the BP does not involve itself in patent issues (only the QUALITY of drugs) sildenafil citrate BP has yet to make an appearance.
BUT NOT SO IN THAILAND!
On the 17th of next month, the Thai version of the MHRA (the GPO – that’s the Government Pharmaceutical Organisation – not the General Post Office!) will launch sildenafil citrate using the brand name Sidegra (but don’t tell Sid – maybe they should have called it Thai-agra) for only 90p ($1.30) per 100 mg tablet – and importantly, just 50p (80c) for the 50 mg size – finally negating the need for that tedious CUTTING.
This will make them HALF the amount that India’s Kamagra pills cost here (after taking the import charges into account).
But what of Britain and America?
How long before Britain releases sildenafil citrate BP? And America (who have no similar organisation) at least “approve” generics?
Given the power big corporations like None The Wiser hold over their governments, this reporter would not want to hold his breath.
But luckily for Brits and Yanks, MOST people are online now. And since their Customs cannot keep up with a FRACTION of the incoming mail, their citizens are free to surf the Interweb to find the best deal they can.
Of course, there are a lot of PIRATES hiding behind the protection of said Interweb – but Kamagra have their own website and as far as this historian is aware, they are trustworthy.
And what of None The Wiser? Well, following their greed, stupidity and arrogance (issuing 25, 50 and 100 mg sizes of their pill for the SAME PRICE, thus clearly demonstrating that the cost of production for them was MINIMAL) they initially only had problems with copy-cats or “clones” (Cialis, Levitra, et al).
But thanks to THIS medium, legitimate products from beyond their reach are now flooding the western market. And with the Wall Street gangsters having given people the need to tighten their finances, many are taking advantage of that fact.
However, it is still a tragedy that for well over a decade now, those for whom this wonder drug should have been a BOON have been denied it, either financially or completely, by stupid (and generally corrupt) governments – and the company who blundered into the discovery, back in 1995.
This punter has always managed to obtain it for the lowest price possible – from ’99 to ’05: £3.50 ($5) a pop – from ’05 until now: £1 ($1.50) – and after the 17th of next month: 50p (80c). And that is with NOTHING EVER spent on “consultations” or prescriptions.
But it is sad that millions of others have not been so lucky…