Bigger and Better: How Pfizer Redefined Erectile Dysfunction

In the pursuit of profits, pharmaceutical companies are continuously looking to expand the market for their products. Drug companies have identified lifestyle drugs as a “growth market.”

The problems that they are designed to treat are easily self-diagnosed—we can all see if we are bald or fat—and as the baby boomers age, the population looking to these drugs will continue to grow. Drug companies, driven by profit, go where the money is.

Because of the potential size of the market for Viagra, paying for it in unlimited quantities will be very expensive. Viagra may only be the tip of the iceberg.

This article examines how Pfizer transformed Viagra from an effective product for erectile dysfunction (ED) due to medical problems, such as diabetes and spinal cord damage, into a drug that “normal” men can use to enhance their ability to achieve an erection and to maintain it (in a “harder” state) for a longer period of time.

To make Viagra into a lifestyle drug, Pfizer needs to convince men that it is the first choice for therapy for any degree of ED, whatever the genesis of the problem. However, drug therapy may not always be the most appropriate treatment option.

The National Health and Social Life Survey data indicate that emotional and stress-related problems such as a deteriorating social and economic position generate elevated risk of experiencing sexual difficulties.

In these cases, Viagra may be less important than counseling or help in finding a new job. These possibilities are never mentioned on the Viagra Web site.

The initial television ads in the US for Viagra used an aging Bob Dole (born 1923) as a spokesman, a 1996 Republican presidential candidate. Since then, Pfizer has refocused its advertising campaign to match the lifestyle message on its Web site.

There is now advertising of Viagra at NASCAR races, and Pfizer hired 39-year-old Rafael Palmeiro, a former Texas Ranger baseball player as a spokesman. Pfizer teamed up with Sports Illustrated magazine to create the Sportsman of the Year Trivia Game.

Between 1999 and 2001, Pfizer spent over US$303 million in direct-to-consumer advertising to get its message about Viagra to men. Besides the large promotion budget, Pfizer has also paid a number of doctors to act as “consultants,” delivering public lectures and appearing in the mass media to expound on ED and Viagra

Pfizer denies that it is targeting younger men or that it is positioning Viagra as a lifestyle drug. Mariann Caprino, a spokeswoman for the company, is quoted in the New York Times as saying, “Have we gone out and given our advertising agency instructions to speak to this young population? No, we haven't” . But the message from the pictures on the Web site, in magazine ads, and from people like Rafael Palmiero is that everyone, whatever their age, at one time or another, can use a little enhancement; and any deviation from perfect erectile function means a diagnosis of ED and treatment with Viagra.

Increasingly, the age profile of men using Viagra reflects the younger audience that Pfizer denies it is targeting. Between 1998 and 2002 the group showing the largest increase in Viagra use was men between the ages of 18 and 45, and only one-third of these men had a possible etiologic reason for needing Viagra (i.e., actually based on a legitimate medical diagnosis)