Bill Gilmore's head is ground zero for what is shaping up as one of the drug industry's hardest fought battles for the hearts -- and wallets -- of American men.
The 43-year-old Baltimore resident is one of the estimated 40 million American men experiencing hair loss, and willing to pay good money for treatments to address it.
On one side of the battle line is Pharmacia & Upjohn, the British drug giant, and its new Rogaine Extra Strength topical solution for treating hair loss in men. The company landed FDA approval Nov. 14 to market its extra-strength solution over the counter.
Its chief competitor: well-heeled Merck & Co., which received Food and Drug Administration approval Dec. 22 to market the first prescription pill for the same condition, Propecia.
Now both pharmaceutical power houses are rolling out high stakes marketing campaigns costing more than $50 million each for national television and print advertising blitzes, in-store promotions, and efforts to convince dermatologists and other hair loss specialists of their products' merits.
Pharmacia & Upjohn says it expects to spend $80 million on advertising, while analysts say Merck has budgeted at least $50 million.
Both companies are banking on their new products to eventually enlarge the current $1.5 billion hair loss treatment market that now draws an estimated 7 million American men.
Area pharmacies and hair loss centers report sales for both products are rising.
Barry Scher, Giant Food Inc.'s vice president for public affairs, said the Landover-based grocery and pharmacy chain is seeing robust sales for Rogaine Extra Strength.
The product, which contains 2.5 times more of the active ingredient minoxidil than original Rogaine, costs about $30 for a 30-day supply.
Demand for Propecia, which sells for between $45 and $50 for a 30-day supply, is gaining steadily, said Scher, even before Merck's launch of its ad campaign.
CVS, the Rhode Island-based chain that is the area's second-largest pharmacy retailer, also reports strong demand for the new Rogaine product and rising sales for Propecia.
Dennis Fallon, who operates Ellicott City-based Apollo International, a chain of hair restoration clinics, said he's been besieged by clients with questions about both products. He expects a clamor for Propecia once Merck launches its mass advertising campaign.
The reason: "Virtually every client I've ever had has asked me the same question: 'Why don't they have a pill for this so I can get my hair back?' "
Propecia won't guarantee that. In clinical studies, 83 percent of men reported Propecia prevented further hair loss; 52 percent reported some hair growth. Only 5 percent reported a "great increase" in crown hair growth. Merck says the drug must be taken for at least three months before results can be expected.
While hair loss specialists say Propecia marks an important turning point in the treatment for thinning hair, there has been some criticism of Merck's pricing of the drug, which is a low-dose version of its Proscar drug.
Merck said its catalog price -- the price offered to pharmacists -- for Propecia, which is a 1 milligram tablet of finasteride, is $1.25. Proscar, used to treat enlarged prostate glands, costs $1.69 per 5 milligram tablet -- or 33.8 cents a milligram.
Christopher Allman, a spokesman for Merck, said Propecia's higher per-milligram price is driven by research and clinical trial expenses that were separate from those for Proscar.
Still, some area pharmacists are skeptical, noting that Glaxo Wellcome also markets its anti-depressant drug Wellbutrin as Zyban, a smoking-cessation aid, for the same price.
Merck has its work cut out persuading stalwart Rogaine users such as Gilmore to try Propecia. After two years of using Rogaine's original treatment for hair loss, he's just bought his first supply of Rogaine Extra Strength.
"I've had good success with Rogaine and figured there would be no harm in trying the extra strength product to see if the results are significantly different," he said.
Key considerations in Gilmore's purchasing decision: price and safety.
For now, said Gilmore, he's wary of trying Propecia, available only by prescription, because he's heard it can cause impotence. Actually, the drug carries a very slight risk of side effects, including reduced sex drive and impotence. Both are reversible by stopping the medication, say doctors.
Pharmacia & Upjohn is the first out of the gate with its mass advertising campaign aimed at men -- including television ads airing during nationally broadcast sports events, such as NBA basketball games, and full page ads in the national publications such as the Wall Street Journal.
John Ruane, a spokesman for Pharmacia & Upjohn, said the company is hoping for a marketing advantage over Propecia because Rogaine Extra Strength doesn't require a prescription.