The erectile dysfunction drug market is shaped by the parallel needs of consumers and industry, with both demanding faster and more reliable performance. Maxine Vaccine explores the fine line between medicine and desire.

This week’s most exciting drug news was the FDA approval for Stendra (avanfil) from Vivus: an erectile dysfunction drug that can take full effect within 15 minutes.

Stendra is the youngest and studliest member of the Viagra family (PDE5 inhibitors), all of which have generic names ending in ‘fil’. Whether that is a play on ‘phile’ (lover) or, more crudely, on ‘fill’ is a question for chemists. It definitely has nothing to do with Phil Mitchell.

The greater speed of action of Stendra prompted urologist Dr Ira Sharlip to make the slightly double-edged comment: “Quick onset of action is important to men.” He added that Stendra would appeal predominantly to ED sufferers “whose opportunities for sexual activity are more casual”.

The new kid in town has the classic side-effects of the PDE5 inhibitor family: headache, lack of sensation, insomnia. But it doesn’t have the rare side-effect observed with Viagra of blue-tinged vision – about which Dr Sharlip said:

“Blue vision with Viagra is uncommon and at worst annoying. Most men who get the blue vision with Viagra don’t care about it.”

Perhaps it just reinforces their sense of living in a blue movie.

But is the impatience of male patients to get it on resonating with the sales professional’s hard-on for the next customer – leaving the clinician as the odd one out in the commercial three-way?

Let’s be honest about this. ED drugs restore reliable sexual functionality to men in whom age and/or circulatory problems have made such functionality unreliable or impossible. They are clinically suitable for men who are in late middle age or old age or have certain medical conditions.

They are not clinically suitable for young and healthy men who want to have more sex for longer, to have sex while drunk or stoned, or to be able to make porn films or imagine they are doing so. Yet that is the natural ‘market’ driven by their brand positioning as performance-enhancing products rather than as medicines helping to restore normality.

The ambiguity of the Viagra brand – is it a medical product or a consumer sex aid? – is reflected in the online market that exists for stolen pills or counterfeit versions of the drug. Just how big is that market? Well, this week it was reported that British fraudster Martin Hickman has been ordered to pay back £14.4 million earned by selling fake Viagra online.

The investigation – one of the biggest ever undertaken by the MHRA – uncovered more than 30 bank accounts scattered around the world, with customers across Europe served via a website hosted in Germany but run by Hickman from his Staffordshire home.

The pharmaceutical industry makes no money from counterfeit drugs – and indeed, it loses custom since those customers will not seek prescriptions. But the question the industry has to ask itself is: does its brand positioning create images and expectations that help to drive a black market in fake drugs?

Remember: a sales rep can do it all night, but only a key account manager can make your breakfast in the morning.

Maxine’s views are not necessarily those of Pharmaceutical Field.

Keen-eyed pharma blogger Maxine Vaccine makes her Pf debut with a look at a classic instance of creative branding.

One of the classic literary studies of marketing is ‘The Lame and the Halt’, written by American journalist Ellis Parker Butler just over a century ago. His character ‘Perkins the Great’ is a brilliant entrepreneur from whose methods we can still learn much about the commercial side of pharma innovation.

The story begins with Perkins and the narrator, his business partner, discussing the possibilities of spring water from an obscure rural district known to the locals as ‘Skunk Swamp’. Perkins describes the product as “sulphur water with a touch of garlic”. His first idea is to sell it as an oral medication for rheumatism.

With the economy of the born marketer, he explains why rheumatism is the ideal target market: “It is prevalent.” He already has the core idea for his marketing campaign: the product will be sold through advertisements across the USA with the catch-phrase Perkins pays the freight.

The real breakthrough comes with his realisation that the product will meet with too much customer resistance as an oral medication. But if customers are advised to bathe in it, not only will they not have to taste it, but they will need to buy more of it. With this application of customer insight, a winning brand is born.

Perkins and the narrator set up a factory on the edge of Skunk Swamp, and are going into business when Perkins has another idea. To add value to the customer service, they can invite customers to save the labels from the massive bottles of spring water – and for every six labels they send back, they will receive the deeds to an acre of the land the water came from.

They target ‘rheumatism districts’ across the USA with a poster and magazine ad campaign – to great effect.

Things get complicated when the Grand Rapids Rheumatic Club of Chicago turn up outside the factory to inspect their “real estate holdings”. Perkins and his business partner make a strategic exit from the market by catching the first train out of town.

Needless to say, this story is a gentle satire on advertising in the days before the FDA. Nothing like that could happen now. Imaginative branding has to be built on the solid foundation of a product whose efficacy is beyond doubt.

But the way in which Perkins innovates his commercial offering – first by introducing a brand-defining procurement concept, then by modifying the product’s application to improve customer targeting, and finally by rewarding customer loyalty with a unique extra benefit – deserves our admiration.

And so does his nerve.