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Three impotence drugs battle to gain more users
January 26, 2004
The television ad shows NASCAR champ Mark Martin
speeding around the racetrack in his No. 6 Ford
Taurus, the word Viagra splashed across his
car and his clothes.
In the 15 seconds the commercial lasts, 135
Viagra
tablets have been dispensed somewhere in the
world - nine every second.
That's 777,600 doses of Viagra a day.
The pioneering medication for impotence
has become one of the world's most widely prescribed
drugs, with a name as recognizable as Nike or
Coke.
"It's like Hoover and vacuum cleaners,"
says Geraint Thomas, spokesman for GlaxoSmithKline,
which makes a rival drug, Levitra. "That
is what we're up against."
An Internet search for Viagra brings up 12.7
million hits, and the official Viagra site has
been visited more than 13 million times.
The baby-blue pill that became the butt of
a thousand late-night talk-show jokes has drug
maker Pfizer Inc. laughing all the way to the
bank. Since its launch in March 1998, 130 million
Viagra prescriptions have been written for 20
million men worldwide who suffer from what is
medically known as erectile dysfunction, or
ED.
And that's just the tip of the ED iceberg.
Estimates are that 30 million Americans suffer
from erectile dysfunction, but only 10 percent
have sought treatment.
And there will be a never-ending supply of
potential patients. According to Pfizer studies,
there is a 12 percent decline in erectile function
for every decade a man ages, and a 3 percent
decline for every 20 pounds he gains. Research
shows the disease will affect half of all men
over the age of 40, and 30 percent of all cases
will be moderate to severe - a veritable ED
epidemic.
It's no wonder there are two new competitors
in the ED arena: Levitra, made by Bayer Pharmaceuticals
and GlaxoSmithKline, which won approval in August;
and Cialis, on the market since December and
touted by partners ICOS and Eli
Lilly as the next generation of impotence
drugs.
All three work the same way, by increasing
blood flow to the penis. None of them are aphrodisiacs
or hormones, and none create desire where none
exists. They're also not magic pills for instant
erections; all require stimulation to work.
The good news, says Aurora urologist Joel Kaufman,
is that Viagra, Levitra and Cialis do help men
who need it. The bad news is that ED probably
is an early sign of other major health problems.
"ED is now thought of as a harbinger of
systemic vascular disease," Kaufman says.
"The problems that cause erectile dysfunction
might cause the same man to have a stroke."
Once thought to be mainly psychological, ED
now is closely linked to hypertension, high
cholesterol, diabetes, alcoholism and smoking.
But getting men with ED to confide in their
doctors isn't easy, for lots of reasons: The
man might not care, he might be sick, he might
not have a partner or he might have a partner
uninterested in sex.
Even more likely: He's in denial, too embarrassed
or unaware that there are treatments that work.
"Men aren't good communicators,"
Kaufman says. "If a woman has a medical
problem, she might share it with friends. But
if a man can't get an erection, he's not about
to tell his buddies."
He might not even tell his doctor. Studies
show most men believe that their doctors might
be either too busy to talk about sex or uncomfortable
with the topic, or that they have more important
health issues to address.
Despite that, the availability, efficacy and
safety of Viagra have taken ED
treatment out of the hands of urologists
and put it into the hands of primary-care physicians,
Kaufman says.
It's also easy to get over the Internet, but
so-called "recreational" use of Viagra
by men who supposedly don't need it is probably
overstated, Kaufman says. The drug won't improve
the sexual performance of a man who has no problems
in that department.
"It's hard to beat normal," Kaufman
says. "It may be they have mild erectile
dysfunction they don't want to admit."
ED covers a broad range of degrees of dysfunction,
but what one man might consider adequate, another
might not, the urologist says.
"The average 50-to-60-year-old man who
has reasonable sexual
intercourse might not have a 100 percent
rigid erection, but it works," Kaufman
says, noting that only 60 to 70 percent is needed
for penetration. "For a 40-year-old man,
that might not be acceptable."
The newest drug, Cialis, takes longer to kick
in than the other two but works significantly
longer - 36 hours, compared with about four
for Viagra and Levitra. Cialis' effect also
isn't diminished by food or alcohol, a problem
with Viagra and, to a lesser extent, with Levitra.
"The huge Catch-22 of it for me is that
so much is dependent on emotion and mood and
the right timing with my partner," says
a 57-year-old Aurora man who asked not to be
identified. "(With Viagra), it's kind of
like being given an order: Become aroused now!'
It doesn't work that way."
Lilly research shows that Viagra's brief life
causes chronic clock-watching, and that couples
want to choose the right moment for sex themselves,
rather than have a pill pick it for them, says
Khoso Baluch, who heads Eli Lilly's U.S. marketing
campaign.
The company plans to focus on long-lasting
Cialis' benefit to couples.
"Make them forget about it," Baluch
says. "Just take a tablet on Friday evening
and not think about it again till Sunday."
Not surprisingly, Pfizer studies show that
Viagra's four-hour window of opportunity worked
well for most men, whose sexual habits are basically
the same, whether or not they have ED.
One Denver man who has tried all three drugs
for his ED likes the effect of Viagra but also
appreciates the anxiety-reducing longevity of
Cialis, which still has an effect for him after
72 hours.
"It hasn't been forced at all," he
says. "With Viagra, I still have anxiety
about when's it going to kick in and how long
it's going to last."
Viagra-maker Pfizer has targeted a younger
audience, dumping its early spokesman, former
Sen. Bob Dole, in favor of front men Martin
and baseball star Rafael Palmeiro. Levitra has
recruited football great Mike Ditka and is a
sponsor of the National Football League - a
not-so-subtle reminder that ED strikes even
the most macho.
Cialis has aligned itself with the PGA and
the Western Open, but it doesn't need a celebrity
spokesman, Baluch says, because the drug's staying
power sets it apart.
Viagra and Levitra commercials never mention
erectile dysfunction, but Lilly says its marketing
approach will be more education-oriented to
help destigmatize ED.
"It's a devastating disease that leads
to other issues in terms of depression and confidence.
And it has implications to the couple,"
Baluch says.
"It's not just a man's disease."
source:-http://durangoherald.com
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