Approved by the Food and Drug Administration last week, the topical ointmentwill no doubt add fuel to the debate over the rising cost of prescriptiondrugs and, specifically, whether insurers should provide coverage forlife-enhancing - as well as life-saving - medications. Vaniqa slows thegrowth of female facial hair by blocking the enzyme that stimulates growth.While the twice-a-day cream is expected to be used by women with excessivefacial hair - beards and mustaches so thick they require shaving, forinstance - dermatologists predict it will also be popular among the millionsof women with much less noticeable hair growth and as an alternative totedious tweezing, waxing, electrolysis and laser removal. Of course, nothingwould prevent a woman from using it anywhere: underarms, legs, bikini lines.And any man bold enough to request a prescription from a dermatologist coulduse the drug too.

"This is an incredibly intrusive problem," says New York dermatologist AlanGreenspan, who conducted clinical trials on the drug. "This is not just forwomen with beards, this is also for women with a little hair on their lip, alittle hair on their chin. Even the least troubled will use it."That's what Bristol is banking on. With three of its most promising"serious" drugs - Vanlev for blood pressure, Tegafur to treat cancer and theanti-viral Lobucavir - all having suffered setbacks, the company is lookingfor a lift. But the prospects for lifestyle drugs "are probably the mostdifficult to forecast," said Alex Zisson, an analyst with Chase H&Q. "Thepatient population is huge but consumers don't think of the condition as amedical problem requiring drug therapy."

Pfizer Inc.'s Viagra, the impotence treatment that is the icon of lifestyledrugs, surprised industry watchers by becoming the most successful drug inhistory within six months. On the flip side, Merck & Co.'s Propecia, forbaldness, continues to disappoint analysts.

But Vaniqa, which started in development as a cancer drug, has some marketforces in its favour, said analyst Barbara Ryan of Deutsche Banc Alex.Brown. Bristol-Myers arguably has more experience in the consumer world thaneither Pfizer or Merck, analysts say, with a larger over-the-counterdivision and therefore greater expertise in marketing and advertising suchproducts. Secondly, Vaniqa is being developed in partnership with the razormaker Gillette Co., which has a track record in marketing campaigns designedaround hair removal. The drug will be aggressively promoted not only todermatologists but to general and family practitioners as well.

Bristol-Myers is also seeking regulatory approval for Vaniqa in Europe andLatin America. Ryan said Vaniqa could take off despite analysts' modestprojections. "I would say, as a woman, the potential for the drug is farbeyond what we expect," she said. "While people don't walk around talkingabout facial hair, we all know the waxing salons are full."

Moreover, Ryan said, unlike a blood-pressure drug, for instance, the realtarget for Vaniqa is the consumer. "Patients will hear about this and asktheir doctor for a prescription, not the other way around," she said. "Thedoctor isn't going to say, `Mrs. Smith, about that hair on your lip.'"That raises the question of cost. Kate Sullivan, director of health-carepolicy at the US.Chamber of Commerce, said each time a lifestyle drugappears, it puts more pressure on employers to cover it.

"But you can only cover so much," she said. "When you're looking atlifestyle drugs ... employers are going to ask themselves, 'Where's themedical benefit?'" In studies, the company said, Vaniqa significantly slowedthe growth of facial hair on 70 per cent of women. In a six-month study of596 women with excessive facial hair, a significant difference was seen asearly as four weeks, and areas where the cream was applied became clear oralmost clear of new growth, said Marty Sawaya, a dermatologist who presentedfindings at a meeting of the American Academy of Dermatology. Side effectsincluded stinging, burning, tingling and acne.

Also, doctors said Vaniqa isn't necessarily more effective than laser hairremoval or electrolysis, but the company expects it will be simple enough towin over the 41 million women in the US a year who it says remove facialhair at least once every six months. The company says Vaniqa could be onstore shelves in about six weeks.