NBC News
updated 11/1/2003 9:35:08 AM ET 2003-11-01T14:35:08

Most of those taking it, don’t like to talk about it. But they’re among at least 20 million men who use Viagra regularly. That makes it one of the biggest-selling prescription drugs in history. Now Viagra is facing new competition, and, some people say that both drugs, the old and the new, are being marketed as more than just medicine. NBC’s Josh Mankiewicz reports.

TURN ON your TV these days, and you’re likely to see an ad featuring a forty-ish guy tossing a football. But exactly what he’s pitching isn’t clear. All we know is that Levitra, whatever it is, somehow allows him to do something he hasn’t been able to do before. Now, he’s doing it every time. He’s happy. So’s his wife.

And if you do ask your doctor about it, you’ll find that Levitra is the newest entrant into the market for drugs that treat what used to be called impotence, known now as erectile dysfunction, or E.D.

Fronting the new campaign is former NFL player and coach Mike Ditka — Iron Mike, as famous for his tough-guy image as for coaching the Super Bowl champion Bears.

Josh Mankiewicz: “Is this tough to talk about?”

Mike Ditka: “No. Not at all. I think it would be tough not to talk about it. I mean, I have a problem. I don’t want my life to come to an end.”

According to one government study it’s a problem for an estimated 30 million American men.

Ditka: “Men of all ages, let’s face it. You don’t like to see doctors. You’ve got this macho image. You know, I’m Iron Mike, that’s not gonna happen to me. But that when it happens to you, you realize how vulnerable you are.”

There was also Bob Dole, back in 1998, speaking for the first anti-impotence drug of its kind: Viagra. Back then, Viagra was pitched as a life-saver for men who, because of serious medical problems, simply weren’t able to have sex. Viagra, we were told, would make the difference.

Now fast-forward to 2003. Pfizer, the company that makes Viagra, is selling about $2 billion worth of Viagra every year, nine pills every second. And now, the ad campaign is less about courage and more about charisma. The new Bob in the commercials is no Bob Dole. For starters, he’s about 30 years younger. And he doesn’t look like a guy with a problem. In fact, quite the opposite.

That’s right. Bob hasn’t even taken Viagra. But just from talking to his doctor about it, he’s suddenly giving off a different vibe, something picked up by both men and women.

Arthur Caplan: “What you’ve got now is a suggestion. You talk about this drug, you invoke the magical chant, and you’re going to start to being on the road to being a sexual being.”

Arthur Caplan teaches medical ethics at the University of Pennsylvania. he also consulted with Pfizer on the Bob Dole ad.

Caplan: “I think what they found as they began to roll the drug forward was the market for the truly impotent filled up fast.”

Mankiewicz: “And now it’s time to sort of expand the market to people who don’t strictly need it but might want it.”

Caplan: “Correct. So a very clever thing was done. Put it over the plate for impotency, then start to pitch on the edges looking for the next market.”

The latest Viagra ads feature 44-year-old Nascar driver Mark Martin and 39-year-old Texas Rangers baseball player Rafael Palmeiro.

Ethicist Caplan, who has seen those same ads, says that what Viagra and its competitors are now selling to men isn’t health, but a change in lifestyle, the chance to regain the sexual stamina of their youth, and a sort of insurance policy.

Caplan: “I think they’re selling to the worried well. That is, people thinking, gee, I’ve had a failure once. Maybe this might help me out. Or if something’s good, a lot more is better. Maybe this is going to help me perform better. Maybe this is going to be the ticket to a rich and active sex life.”

Mankiewicz: “If I ask the drug companies, are you counting on recreational use and they say absolutely not—”

Caplan: “I’d say they’re lying.”

In response, the drug companies say their products are marketed solely for a medical condition.

Janice Lipsky: “Viagra’s a good thing for society.”

Janice Lipsky heads the Viagra team at Pfizer pharmaceuticals.

Mankiewicz: Viagra’s not an aphrodisiac.”

Lipsky: “Mm-mm. [negative]

Mankiewicz: “Viagra will not solve your medical problems.”

Lipsky: “No.”

Mankiewicz: “And Viagra will not inherently make your marriage better.”

Lipsky: “That’s true.”

Mankiewicz: “And yet, that’s the way Viagra and every other drug’s being sold.”

Lipsky: “I beg to differ, if I may. If a man needs to get an erection 100 percent of the time, and Viagra can help him, he’s entitled to pursue that treatment.”

Mankiewicz: “So Viagra and drugs like it are not just for people who can’t have sex, they’re for people who want to have better sex?”

Lipsky: “Well, Viagra is for people who have problems with erections. And the issue is that that is sort of subjective.”

And what do Viagra’s competitors think?

Mankiewicz: “Should you take a drug because you need it? Or because you want to sort of turn the clock back?”

Ditka: “Well, I think you should take it because you need it. If a person wants to take a drug to enhance their sexual prowess, that’s a whole different thing.”

But in Brazil, when soccer star Pele showed up on TV selling Viagra, the Brazilian government thought the ads went too far, that they promoted recreational use and the ads were banned.

It’s a battle with few borders. In this country, Pfizer wants to keep Viagra the market leader. And its attorneys are suing the makers of Levitra, claiming Pfizer’s patent is being infringed.

Mankiewicz: “I’m amazed at the sort of anger and contentiousness this has generated between the drug companies.”

Ditka: “The market is...that’s why everybody’s so competitive. That’s why everybody’s getting mad. That’s why they’re starting to throw lawsuits around. Because there’s a lot of business out there. There’s a lot of men that need help. And a lot of men aren’t getting help right now. And when they all do, this is going to be a huge, huge business.”

A third E.D. drug is likely to be on the market soon. It’s called Cialis, and is expected to receive government approval by the end of the year.

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