The introduction of the first oral treatment for erectile dysfunction (ED), sildenafil (Pfizer's Viagra), in 1998 revolutionized management of this condition. As the first effective and safe oral treatment for ED, sildenafil has become the unrivaled therapy of choice. However, sildenafil's therapeutic profile does leave room for improvement. A new oral drug with greater efficacy or faster onset of action, as well as a better cardiovascular profile (i.e., one that could be used concomitantly with nitrates), would fulfill the most important pharmacological unmet needs in the treatment of ED. Erectile Dysfunction, a new study published by Decision Resources, Inc., examines sildenafil and other current treatments for ED and evaluates the potential of emerging ED therapies.

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Although sildenafil is effective and safe in the majority of ED patients, opportunities remain for further development of oral pharmacotherapies. Therapeutic unmet needs in ED relate not only to the need for more effective agents with an improved cardiovascular profile but also to the need for agents that will allow men to engage in sexual activity with greater spontaneity, frequency, and longevity. Although sildenafil is likely to remain the leading drug, Cialis (Eli Lilly/Icos) has a duration of action (24 hours) that is likely to provide an advantage over sildenafil for some men. For this reason, it is the most eagerly anticipated of the new phosphodiesterase (PDE) inhibitors. Physicians believe that a fast onset of action (15 to 20 minutes, as opposed to sildenafil's one hour) would be an even more significant selling point for a new PDE inhibitor.

TAP Pharmaceutical's sublingual apomorphine (Uprima) will be most suitable for men with mild to moderate psychogenic ED. Smaller market opportunity exists for other oral agents and for intracavernous injection therapies. A niche market will remain for intracavernous injection therapies because they will continue to be the most effective second-line options. Physicians are enthusiastic about Senetek's new combination injection therapy, Invicorp, which uses vasoactive intestinal peptide (VIP) and phentolamine. Assuming that Invicorp is approved, we believe it could become the injection therapy of choice.

In 1999, total sales of drugs to treat ED in the seven major pharmaceutical markets (United States, France, Germany, Italy, Spain, United Kingdom, and Japan) were $934 million. We expect this market to grow at an annual rate of 10% over our 1999-2009 forecast period, reaching $2.5 billion in 2009. Growth will be fueled by increases in diagnosis and treatment rates as new therapies reach the market, particularly in the first half of the forecast period, and by general population aging.

Erectile Dysfunction is part of Mosaic, one of six Pharmacor services that evaluate the commercial potential of drugs in research and development.

Decision Resources, Inc., is a world leader in pharmaceutical research publications, advisory services, and consulting designed to help clients shape strategy, allocate resources, and master their chosen markets. Founded as a subsidiary of Arthur D. Little, Inc., the company has provided strategic information services for 30 years.

Contact: Frank Sama, 781.487.3753 (telephone), 781.487.5750 (fax), or (e-mail). In Europe, contact Francoise Bidart, +32.2.351.4082 (telephone), +32.2.351.2347 (fax), or (e-mail). In Japan, contact Makiko Yoshimoto, +81.3.5401.2615 (telephone), +81.3.5401.2617 (fax), or (e-mail).


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SOURCE: Decision Resources

Contact: Frank Sama of Decision Resources, 781-487-3753,

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