MEN'S HEALTH Competitors fight Viagra name in race to get share of ED market

Two new competitors take on Viagra's well-recognized brand name.
SCRIPPS HOWARD NEWS SERVICE
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, an estimated 135 Viagra tablets have been dispensed somewhere in the world -- nine every second.
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, a 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.
Laughing it up
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.
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 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 is an aphrodisiac or hormone, and none creates desire where none exists. They're also not magic pills for instant erections; all require stimulation to work.
Good and bad news
The good news, says Aurora, Colo., 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.
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."
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.
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.
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."
Dumped Dole
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.