Viagra Vs. Levitra


M. Herper and A. Lagorce, 10.06.03, 7:00 AM ET

Viagra
Generic Name:  Sildenafil citrate
Manufacturer: Pfizer
Approved By FDA:  March 27, 1998
Sounds Like: Vigor, or Niagara
Color:  Cooling blue
Cost Of Pill: $88 for ten tablets on drugstore.com
U.S. Sales (2004 Estimate): $919 million*
How Fast Does It Work: The FDA-approved package insert says it takes 30 minutes to 120 minutes, but new studies say it takes less than 15 minutes in most men.
Famous Face: Politician Bob Dole
Recent Promotional Campaign:  Young-looking men were happy because they asked their doctor about Viagra.
How It Works: Inhibits an enzyme called phosphodiesterase type 5 (PDE-5), making muscle in the penis more likely to relax and allowing blood to flow in, causing an erection.
Selling Point: Good track record. Has been used by 20 million men worldwide.
Levitra
Generic Name: Vardenafil hydrochloride
Manufacturers: GlaxoSmithKline, Bayer
Approved By FDA: Aug. 20, 2003
Sounds Like: Levitate, or la vita, meaning 'life'
Color:  Orange (complete with flame logo)
Cost Of Pill: $88 for ten tablets on drugstore.com
U.S. Sales (2004 Estimate): $174 million*
How Fast Does It Work: Levitra label says to take it 60 minutes before sexual activity, but studies have shown it can work in as little as 16 minutes. May be more likely to work the first time.
Famous Face: Chicago Bears coach Mike Ditka
Recent Promotional Campaign:  Ditka says he has suffered from erectile problems, and encourages men to "stay in the game."
How It Works: Inhibits an enzyme called phosphodiesterase type 5 (PDE-5), making muscle in the penis more likely to relax and allowing blood to flow in, causing an erection.
Selling Point: May work faster, and for men in whom Viagra failed.


Call it getting a rise out of the competition. In its first month of sales, Levitra, the new erectile dysfunction treatment from Bayer and GlaxoSmithKline, managed to grab a 50% share of prescriptions in newly diagnosed patients. Sounds impressive, but analysis by Bernstein Research of data from health information provider IMS Health reveals another side to these figures. Viagra maker Pfizer still has well more than 95% of total prescriptions for impotence.

Worse, Bernstein pharmaceuticals analyst Richard Evans sees U.S. sales of only $425 million each annually for Levitra and another erectile dysfunction drug, Cialis, being developed by Eli Lilly and ICOS. Cialis is expected to go on the market early next year. Viagra, which now has U.S. sales of $1 billion, will, by Evans' reckoning, drop by nearly half. The new drugs will merely cannibalize the existing market.

Not everyone is so bearish. Myron Murdock, medical director of hisandherhealth.com and a doctor who has conducted clinical trials with all three drugs, thinks the flood of direct-to-consumer ads will get men into their doctor's office. All three drugs work by inhibiting the same enzyme, but he sees significant advantages to the new entrants. Levitra is a more potent molecule, and it seems to work faster and on a full stomach. (Expect more studies from Pfizer, showing that Viagra works fast and with food, to keep up.) He says Levitra also clearly works better in hard-to-treat cases, such as men whose impotence is caused by diabetes.

Cialis, on the other hand, clearly works for 36 hours or more, making it an ideal choice for men who are very sexually active, Murdock says. He still gives Viagra the edge in treating female sexual dysfunction, a yet-unapproved but potentially lucrative use. Pfizer is five years ahead of the competition in that area. Murdock also notes another advantage for Levitra. Viagra patients have been ordering high-dose pills and splitting them, because all doses come at the same cost. Levitra, a small, hard orange pill, is much more difficult to cut, so at least it won't have to deal with sales reduced by pill splitting.