Viagra, Cialis, Levitra — The Hegemony In A Multi-Billion Dollar Market?

Viagra, Cialis, Levitra — The Hegemony In A Multi-Billion Dollar Market?
Erectile Dysfunction (ED) is a disease that has plagued mankind for centuries. However due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time and still continues to be an uncomfortable topic today.

In the past, the Latin term impotentia coeundi simply meaning the inability to insert the penis into the vagina was used to describe this condition. But as our understanding of the subject improved, so did its definition and we now know that ED is the inability to maintain an erection. The reason behind the increased public awareness: Viagra. The first pharmacologically approved remedy for impotence, Sildenafil (the active ingredient in Viagra) entered the market in the 1990’s with much media hype and advertising, making it socially acceptable to discuss ED in mixed company.

In recent years, Viagra has been joined by two other drugs, Cialis and Levitra. This veritable menage a trois of giants have dominated the ED market turning it into a multi-billion dollar industry worth more than 2 billion dollars. Which brings us to the question, is there any room left in the ED market for interested newcomers?

Sildenafil, Vardenafil and Tadalafil are the active ingredients in Viagra, Levitra and Cialis respectively. All three chemicals act by inhibiting an enzyme called PDE-5 that usually interferes with muscle relaxation and increased blood flow to the penis. By blocking PDE-5, these pills clear the way for an erection. These drugs however do not give the patient an automatic erection – sexual stimulation is still needed. Just as these pharmaceuticals create similar desired effects, they also give rise to certain side effects: headaches, heartburn, flushing, low blood pressure, to name a few. They also do not mix well with alpha blockers and nitrate medication.

It has been estimated that only 10 to 15 percent of the 30 million men who suffer from erectile dysfunction actually seek treatment. Showing that even though these drugs have been available in the market for a few years, men still find it difficult to take the first step. The introduction of new competitors however could see a dramatic increase in the market as increased awareness due to media campaigns drives more men to consult their doctors and then back to the pharmacies with new prescriptions. About 50 percent of men aged 40 to 70 suffer from mild to severe ED, thus looking at the numbers, there is tremendous potential for newcomers if they have what it takes.

To be competitive, new treatments will need to be unique. Key differentiators that would be welcomed by both the prescribing community and sufferers alike include a different time of onset or duration of action. Treatments don’t have to be in the form of pills either. Research has shown that inhalers, provided they show comparable efficacy, would work well. They’re easy to use, and would facilitate quicker onset.

Additionally, once-a-day formulations may be useful to chronic patients, while a different subset of men can continue to take the agent as and when the need arises. Add in a creative, well financed advertising campaign and perhaps a catchy name and the new drug is definitely here to stay. Current statistics claim that there are 21 other drugs (such as herbal treatments and dopamine receptor antagonists) in various stages of research and development already in the pipeline. So perhaps very soon we will witness the fall of the Viagra-Levitra-Cialis Dynasty and see the rise of fresh new competitors who more than measure up to their older counterparts.
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