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It must be noted however, that these sentiments rely on the belief that physicians 27 are selfless workers on the patient’s behalf who only do what is necessary for them, including prescribing only time-tested and cost-effective medications. If only this was always true, then pharmaceutical companies, through direct-to-patient advertising, would be exploring a new method of increasing sales: through the obtrusion of physician-patient relations. This method however, is not new, but rather, has been employed by drug manufacturers for some time. Although, pharmaceutical companies are investing large amounts of resources into consumer advertising, they are also spending increasing amounts on convincing physicians to prescribe their products: while half a billion dollars was spent on television commercials during the first nine months of 1998, five times as much, or $2.7 billion was spent on sales and promotional efforts to office-based physicians (Maguire, 1999). With regards to Viagra alone, these efforts concentrate on keeping doctors updated on success stories, educated about sexual dysfunction, and stocked with information sheets, free Viagra samples, educational videos, and other Pfizer paraphernalia (Loe, 2004). After all, at nearly $10 per pill, physicians still serve as the official gatekeepers to lucrative profits from sales of Viagra for pharmaceutical companies. With regards to the traditional method of disseminating drug-related information about new treatments to medical professionals, individuals at Pfizer decided to exercise a more powerful approach. This occurred by financially supporting key researchers and publications contributing to the universe of knowledge relating to erectile dysfunction. As such, the dispersion of scientific information regarding erectile dysfunction and its treatment by Viagra was to an extent skewed towards the benefit of Pfizer. In addition, a large volume of published literature regarding Viagra, especially before its approval and immediately after, created a false sense of importance and interest on the drug, which was eventually, termed ‘The Viagra Phenomenon’. It is no secret that pharmaceutical manufacturers, as others in industries involved in the development of products, often fund researchers, their projects, symposia and certain professional gatherings. In return, certain physicians “moonlight as consultants” for these companies (Stipp et al., 1998). Experts and marketers are increasingly dependent upon one another, as experts need funding to research, and marketers need expert status to achieve legitimacy and to publish data. This arrangement constitutes a large portion of the modern medical landscape. Katherine Greider, author of the book entitled The Big Fix: How the Pharmaceutical Industry Rips off American Consumers, writes that this fusion of science and capitalism has left America (as can be assumed for Canada as well) “oddly impoverished in the way of unbiased, approachable information about the usefulness and cost of one drug versus another” (2003; pg. 2). Support for this statement is found in a disturbing study in The New England Journal of Medicine, which revealed that 96% of medical experts who published studies or other articles supporting the use of certain controversial blood-pressure drugs had financial ties with companies that make them, while only 37% of those who wrote articles critical of the drugs had such ties. The practice of stating one’s affiliations, potential conflicts of interest, and sources of research funding when submitting a publication serves as one method of acknowledging such links. However, although a journal such as Current Medical Research and Opinion requires that authors affirm that the publication of their article is free of any conflicting commercial interest, and that no commercial funding is associated with the given paper, the affiliation or interests of the authors are undisclosed. Often, Pfizer’s support is disclosed and acknowledged by authors. Aside from such instances where funding and professional relationships are overtly disclosed, however, the corporation also supports certain influential projects cryptically.

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