The makers of the erectile dysfunction drugs Viagra and Cialis are yanking $50 million in advertising from TV broadcasts of NFL games, their top contact point with male consumers. Indeed, the makers of both drugs are going dark with their costly ads across a variety of sports programs, including summer pro golf and tennis.
After billions of dollars in revenues reaped every year for their manufacturers, Viagra and Cialis both are Big Pharma hot shots no longer. They may have erased any remaining decorum on TV over the years with their advertising and marketing hype. But they cannot outrun a typical drug’s economic life cycle. Their patents are expiring, and their makers are trying to figure how best to exploit their profitable, branded drugs when generics—already regulator approved and ready to go—saturate markets and drive prices down, perhaps as early as next year.
Viagra may find another life as an “orphan drug,” enjoying new and special market protections as a therapy for at least a quarter of a millions Americans who suffer from an unusual condition. In this case, its key ingredient, sildenafil, may be useful for youngsters with high blood pressure. Its manufacturer has gotten a patent extension and waged a bitter court battle with generic makers to keep Viagra a robust brand.
Cialis, of course, has a similar key ingredient but its maker is going a different economic route, as this drug’s patents expire. Eli Lilly has decided to work with Sanofi, another maker, to split up global territories and to try to get regulatory approvals for Cialis to become an over-the-counter ED treatment, purchasable with greater patient privacy with just guidance from a pharmacist—not as occurs now, say, in the United States, where a doctor’s exam and prescription is required. Viagra may be in consideration in Britain soon for OTC status, too. The overpowering popularity of users scouring the Internet for cheap, convenient supplies of ED drugs—no matter whether they actually are safe or effectiveness—may help persuade regulators to allow the real meds to be dispensed without prescription.
To be sure, Viagra and Cialis had been flagging in revenues for awhile, dogged in part by their brand costs and controversies over whether insurers and Uncle Sam should pay for ED care, which critics derided as not a medical necessity but a lifestyle enhancement. Others disagreed.
But the drugs exemplify how all kinds of costs get crammed into medical care, helping to explain how Americans pay skyrocketing prices for medical services and goods that aren’t nearly so expensive anywhere else in the world. The drugs are inexpensive and more easily available outside the U.S., where, without insurer coverage, a single pill can go for as much as $50 or so. Our medical system is crammed full of drugs that are setting price records, especially some that might benefit more patients if they just weren’t peddled in such specialized ways that only fatten corporate profits. Medicine has become a big business, where overbilling is a notorious, bothersome, and costly concern, and where even a seemingly simple, good and routine aspect of a doctor’s visit for the mostly healthy among us—a heart check with an office electrocardiogram or EKG—actually results in a cascade of more, unneeded, and expensive tests and procedures.
As our lawmakers chase after ways to “fix” the health care system by stripping tens of millions of Americans of affordable health insurance, we throw money at therapies like online “brain” games that aren’t proving their effectiveness against age-related cognitive declines, expensive night-breathing systems that may help us sleep better but may not have the promoted benefits for heart health, and, yes for a growing army of omnipresent four-footed friends touted without evidence as supports for our mental well-being.
In my practice, I see not only the huge harms that patients suffer while seeking medical services but also the pervasive, corrosive effects of hype and costs on our medical care. We have the world’s priciest health system. We all need to make it work much more efficiently and effectively for us so we don’t go bankrupt while seeking our chosen pleasurable pastimes, amorous or sporting.