Even if they're watching today's NFL conference championship games with their mothers, television viewers will be counseled in luring tones about the joys of erectile dysfunction medicine.

But the drug companies making those advertising advances are still waiting for all the talk to translate into action.

Despite heavy marketing from the makers of Viagra, Cialis and Levitra -- the big three in anti-impotence medications -- sales in the erectile dysfunction market leveled off last year.

One reason is that many ED sufferers took free samples from their doctors but didn't get prescriptions filled, said David Pernock, senior vice president for GlaxoSmithKline. The drugs might not meet some men's great expectations, others say, adding that age and economics also are limiting factors.

Glaxo, whose consumer health care division is based in Moon, collaborated with Robinson-based Bayer Corp.'s German parent to make Levitra, and the companies plan to promote it heavily during today's games as part of a three-year marketing deal with the NFL.

Levitra ranks third among ED medicines, and Pernock admits that sales were disappointing during 2004. But the Pittsburgh native and lifelong Steelers fan dismissed that with a football analogy.

"We didn't get rid of [Coach Bill] Cowher when he was 6-and-10, did we?" Pernock said, referring to the team's record last year.

"There's an awful lot of sampling going on," Pernock said. "But we're not discouraged, we're encouraged. There was a 64 or 65 percent increase in the number of men talking to their doctors about ED in 2004."

Sales for the top five erectile dysfunction medications during the first 11 months of 2004 reached $1.22 billion, according to the market research firm IMS Health, but that represented only a 10 percent increase over the same time period in 2003.

The erectile dysfunction market grew by 16 percent during 2003, when both Levitra and Cialis, from Eli Lilly and the biotech firm ICOS, were introduced.

The two newcomers, seeking to take market share from Viagra with aggressive advertising, were somewhat successful.

While Viagra had at least 90 percent of the market from 1999 through 2003, its share dropped to 73.9 percent in the first 11 months of 2004, according to IMS Health. Cialis had 13.6 percent share in that same period, while Levitra captured a 9.4 percent share.

Between January and October 2004, the companies spent $132 million on Cialis advertising and $128 million on Levitra, according to TNS Media Intelligence. Pfizer spent $83 million promoting Viagra before pulling its ads due to Food and Drug Administration concerns about the ads' content.

It's pretty clear that marketing blitzes expanded the market. Patients who never before talked about erectile dysfunction suddenly started asking questions, said Dr. Walter O'Donnell, chairman of urology at Mercy Hospital.

But it can only go so far. A lot of older men with erectile dysfunction just don't care anymore, O'Donnell said. Others use a lot of samples because they can't afford the prescription or they are comparing side effects.

Cialis, for example, is marketed as the only erectile dysfunction medication that can work for as long as 36 hours. But the expanded window for potency also means more hours with headaches or other side effects for some men, O'Donnell said.

"We're starting to see some tapering" of demand, O'Donnell said.

Could it be that men using the drugs don't get the results they hoped for?

There's some evidence that might be the case, said Dr. Ken Smith, a researcher at the University of Pittsburgh who is studying the impact of Viagra on patients' quality of life.

"In the small group that we looked at, where we did have before-and-after-Viagra quality of life values, there wasn't the quality of life change you might expect," he said. "But we would need a much larger group to make that conclusion definitive."

At the same time, the drugs help some men with psychogenic impotence "get over the psychological hump," O'Donnell said, while it helps other men perceive their erections more positively.

"I call it the 'First class' effect -- there's something about sitting in the wider seat and the free drink," said Dr. Joel Nelson, the chairman of urology at the University of Pittsburgh. "The plane lands at the same time, but people just like it better."

In most of Europe, where erectile dysfunction sales have lagged due to prohibitions on most direct-to-consumer advertising, Bayer agreed earlier this month to buy GlaxoSmithKline's co-promotion rights.

"We felt that we were strong enough in Europe to do it ourselves," said Attila Molnar, Bayer Corp.'s president and CEO.

Levitra ads will be "refreshed" before spring, Pernock said, but viewers this weekend will continue to see the "My Man" ads, which feature an attractive woman describing the drug's impact and a "quality experience." Total spending for Levitra ads during football games between January and October 2004 was $12 million, according to TNS Media Intelligence.

"We're going to be very prominent during both games this weekend," Pernock said. "We think it hits our demographic extremely well."

source:-http://www.post-gazette.com