Cialis Dares to Be Different

Cialis is the drug with the ear-catching TV commercial. A man and a woman repose on their outdoor sun deck -- sitting in his-and-her bathtubs -- contemplating the countryside as an announcer intones about the drug's 36-hour window of opportunity and warns about the (rare) side effects of four-hour erections.

When you're the newest entrant in a pharmaceutical market, you need to capture the public's attention quickly.

The people promoting Cialis -- the biotechnology company Icos ( ICOS) and the multinational drug giant Eli Lilly ( LLY) -- tried something that their competitors hadn't tried before. They ran a TV ad that described what an impotence drug does.

But in order to present such an ad, they also had to list Cialis' possible side-effects. That's a requirement by the Food and Drug Administration, which says, in effect, that ads describing what a drug does for you must also say what the drug can do to you.

This type of ad is common in newspapers and magazines, where readers can check the fine print about side effects, but the descriptive format is becoming more common on television for anything from cholesterol fighters to antidepressants to antihistamines.

But Cialis, which reached the U.S. market in late November, was the first impotence drug to use such a TV commercial. The ad made its debut during the Super Bowl.

A Strategic Decision

"The first launch advantage is a very powerful advantage in pharmaceutical marketing," said Leonard Blum, vice president of sales and marketing for Icos of Bothell, Wash., referring to the five-year-plus head start for Viagra and the three-month lead for Levitra.

Because drug marketing depends on what the FDA allows on a drug's label, Eli Lilly and Icos decided to promote the drug's major distinction: It stays in the body longer than the competitors' drugs. Even the FDA remarks that Cialis is "different" than other medications because it can improve erectile function for up to 36 hours.

Blum said the TV ad and print ads are designed to convey the drug's flexibility of use, regardless of the smirks and wisecracks that have emanated from comedians and late night talk show hosts. The drug's label and its marketing emphasize Cialis was not tested to gauge multiple intercourse attempts with a single dose.

If you look at the erectile dysfunction drug labels, you'll notice that each drug works by increasing blood flow to the penis. You'll also notice that their side effect profiles are similar. Each drug label warns about priapism, or extended erections; each one warns against using the drug with nitrates, such as nitroglycerin patches; each one cautions men with heart disease to talk to their doctors before taking any of the drugs; and each one cites headache, indigestion and flushing as common side effects detected in clinical trials. (There are some differences: Compare the labels posted on the respective drugs' Web sites.)

But you won't hear about side effects from ex-football player and ex-coach Mike Ditka when he's talking about Levitra or from baseball star Rafael Palmeiro when he promoted Viagra on TV commercials. That's because they never describe the purpose of the drugs.

Different Approaches

The maker of Viagra has decided to keep the detailed information in print rather than on television, said Janice Lipsky, U.S. team leader for Viagra at Pfizer ( PFE). "Our print ads contain the full information; there's more time to read the details," she said.

Lipsky questioned the "tastefulness" of running descriptive TV commercials about impotence during family viewing hours.

Earlier this year, Pfizer announced that it was abandoning eight years of unsuccessful research to determine if Viagra could treat female sexual dysfunction; but Lipsky said the company hasn't abandoned marketing the drug with women in mind. One TV ad, for example, shows a man telling his wife that he had taken care of several chores, including calling a baby-sitter.

"We think that our advertising speaks to women even though they are not targeted directly at women," said Blum, the Cialis marketing executive. "Our ads talk about the right moment. We think the qualities of Cialis appeal to the partner as well as the man with erectile dysfunction. Our ads never show a man by himself or a woman by herself." He said there are no plans for hiring a spokesman for Cialis.

Mike Ditka, the spokesman for Levitra, probably won't appeal to many women, but that's OK for GlaxoSmithKline ( GSK) and its partner Bayer ( BAY).

"Our challenge is not against the competition but to reach out to men about treatment," said Michael Fleming, director of U.S. pharmaceutical product communications at GlaxoSmithKline. "Our ads have hit the mark; we've had positive feedback."

Levitra has had a TV commercial with a woman -- the one with a man throwing a football through a swinging tire roped to a tree -- and Fleming said his company will consider more descriptive TV ads. But when launching Levitra, his company wanted TV ads that "were appropriate and tasteful because they were being shown during the family hour."

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