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Swelling Sales: Lilly to Push Cialis for Prostate Health

Eli Lilly (LLY) hopes to market its erectile dysfunction drug Cialis as a treatment for middle-aged men with enlarged prostates, in yet another example of the company's determination to wring new innovations out of one of its star products.

The news was buried in a lengthy presentation to Wall Street analysts on June 30, but it typifies how clever Lilly's management of the drug has been. In Q2 2011, Cialis is expected to overtake Pfizer (PFE)'s Viagra as the No.1 grossing ED product -- no mean feat considering Pfizer invented the category. Lilly published this slide showing Cialis beating Viagra in sales in March:

Both Pfizer and Lilly have been jazzing up their respective franchises with new ideas around the drugs' delivery and availability:

  • Lilly:
  • Cialis is available in a daily-dose form so that the act of taking the pill is psychologically divorced from the problem it's intended to solve.
  • Cialis is also available in a 36-hour version, called "le weekender" in Europe.
  • The company expects FDA action on its application for Cialis for benign prostate hyperplasia (enlarged prostate, basically) by year-end 2011.
  • Pfizer:
  • A chewable version, Viagra Jet, will be launched in Mexico.
  • A non-prescription version will be available in in some U.K. drugstores.
  • A mid-price generic version, named Avigra, will be available in New Zealand when Viagra goes fully generic there.
Both companies have raised the prices of their drugs -- a sure sign of good corporate strategy. Lilly believes the BPH market is worth $4.2 billion, and that 50 percent of men with ED have BPH:


It's a great marketing idea because it fits with everything else Lilly has figured out about how the ED market works: If you can allow men to not think about their impotence when they take the pill, you can sell more of it. In the case of BPH, men may be able to take it for a non-sexual, relatively unembarrassing reason. Cialis is basically denial -- men's favorite sexual emotion! -- in pill form. BPH affects a majority of males to some degree after age 50 and is sometimes a precursor to prostate cancer.

There is some evidence that Cialis actually works on BPH. An early Lilly study says it worked. Two literature reviews concluded the same. If you want the nitty-gritty, here's the scientific difference between how much urine remains on average in the bladder of men with BPH who are taking Cialis vs. those on the placebo:

Mean post-void residual volume was 61.1 ± 60.4 mL at study entry and 42.2 ± 64.1 mL after the open-label extension period.
The only note of caution here is that it's not clear whether Cialis' smooth-muscle relaxation properties are the cause of its benefits for BPH. It may be that Cialis' effects on sexual function have a secondary effect that's good for the prostate, which is the focus of this infamous set of studies showing that masturbation is bad for men in their 20s but good for men in their 50s.

Everything comes to he who waits (for the FDA), so to speak.

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Image by Flickr user Valerie Everett, CC.