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‘The scourge of the century’

August 12th, 2005

Dr Petra

Anyone paying attention to the financial press this week might have noticed an interesting theme.

The major pharmaceutical companies have all been hard at work trying to drum up trade for their sex drugs through a number of new schemes, media campaigns and ‘medical’ promotions.

Eli Lily who market the erectile dysfunction drug ‘Cialis’ have launched a US television advertising campaign announcing the ‘Promise program’ where men can download vouchers for three Cialis tablets from their website. You take the voucher to your doctor who, viewers are told, will prescribe the drug for free. If you like it you’ll get another three free goes, or three free alternative erectile dysfunction drugs.

The Cialis brand team leader claims this approach has never been tried before in the history of the pharmaceutical industry. My guess is if it works this may well become standard practice.

The worry about this advertising campaign is it can only work if only men with genuine erectile dysfunction apply for the free trial, are thoroughly screened by their doctor prior to taking the drugs, and are fully evaluated afterwards. The alternative is that men will misunderstand the purpose of the drug and think perhaps it’s an aphrodisiac or will make them good in bed, that men who don’t have an erectile dysfunction will still apply for the free tablets, and doctors could honour the free prescriptions without checking patients first.

Meanwhile, Cialis’ rival Viagra (made by Pfizer) has launched a campaign to encourage men to have easier access to their drugs by stressing erectile dysfunction is both widespread and embarrassing.

A urologist announced at a Viagra funded press conference this week that by 2020 185 million men in Asia alone will have erectile dysfunction. ‘It may be the scourge of the century….we better prepare ourselves for something worse’.

Interesting. I assumed health and gender inequalities, diabetes, HIV, heart disease, poverty and starvation, lack of access to affordable medication and war would be more of a scourge.

The press conference then introduced their ‘e card’. Where men could present an ‘e card’ prescription for Viagra at their local pharmacy without having to ‘say a word’.

There are men who for various reasons have genuine problems with erectile dysfunction. And with a full health check from their doctor and advice about their condition, prescribed medication can help them. However, these campaigns aren’t just aimed at those men because all men get to hear about them. Meaning men who don’t have erectile dysfunction may incorrectly assume any occasional lack of erection is both embarrassing and a medical crisis. They’ll not realise it’s a natural response to stress, overuse of alcohol or relationship problems and it makes them prey to free drug trials or being able to access medications without having to discuss their anxieties or problems with anyone.

Whilst there are some positive moves around advertising of erectile drugs (for example in the US they’re no longer going to be shown during children’s viewing hours or at events like the superbowl), companies are also planning to target women as needing medication for their sex lives.

Datamonitor reported this week “there is the potential to develop a parallel market to that of male erectile dysfunction, which is now a multi-billion dollar arena. Success of drugs for FSD will depend on physician and patient education and overcoming difficulties in patient presentation and diagnosis…..Female sexual dysfunction affects an estimated 84 million women across the seven major pharmaceutical markets and represents a significant opportunity for investment. The condition can affect a woman’s desire, ability to become aroused and orgasm and may include sexual pain. Despite the high prevalence, FSD is poorly understood and there are no currently approved drugs treatments”

Now this is very interesting. FSD is actually very well understood. Women can have problems with pain during or after sex, they may well lack desire, or find it difficult to orgasm. We know this. We also know how psychological and physical health conditions can lead to sexual problems in women, as can relationship difficulties and a lack of confidence or sexual knowledge. We know sexual problems can be eased by a number of factors including education, empowerment, masturbation, sex therapy, couples counselling, and treatment of existing physical or psychological conditions.

Whilst many women may report sexual dissatisfaction, that’s not the same as dysfunction. And medication – currently proposed in the form of hormonal treatment – is the last treatment option only for use if the other interventions described above don’t work. Not the first port of call for all women who don’t fancy sex when their partner does.

There is a great scourge of the century, but it is not sexual dysfunction. It is medicalising sex to the point that anything other than perfect performance requires a tablet, gel or patch. It’s creating problems and making us afraid and uncertain so we buy into the idea we need medication – and makes certain pharmaceutical companies very rich indeed.

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