There’s no doubt about it: Viagra® (sildenafil) is one of the most instantly recognisable brands in the pharmaceutical market. This month, Pf looks at how this brand has become so well established, and what it means to the Pfizer sales team to be part of what has become a blockbuster. PFIZER launched Viagra® in September 1998 in the UK, amidst a flood of news stories and publicity, following a thirteen-year development programme worked on by over 1500 Pfizer staff. The product revolutionised the treatment of erectile dysfunction (ED), immediately offering significant advantages over other medical approaches for treating ED both in terms of ease of administration and cost. An Award Winning Product In recognition of their ground-breaking research and success, Pfizer was awarded the prestigious Prix Galien 2000 award for scientific excellence and innovation. This award recognised Pfizer’s pioneering discovery of the role phosphodiesterase- 5 (PDE-5) inhibitors play in the treatment of ED. The Prix Galien is considered within the industry as the most important award for innovation in the development of new drugs. Pfizer has also been recognised outside industry circles, gaining the Queen’s Award for Enterprise in April 2001. This award was made for the innovative discovery and development of Viagra® and was a tribute to Pfizer staff for their dedication to the continuing success of the company; and their commitment to those who benefit from the product. Standing up to the Competition with a Proven Safety Record In the past four years, three more oral preparations from other companies have been licensed in the UK for ED. Following reviews and published evidence on all of these products, sildenafil (Viagra®) still remains the first-line drug treatment for men with erectile dysfunction.¹ A four-year review of the safety of Viagra® concluded that it has a good safety profile and it has a low discontinuation rate due to sideeffects.² Doctors have confidence in this product that works for all types of patients with ED and is safe to use in those with stable cardiovascular disease and diabetes. Overcoming the Embarrassment of a Very Common Problem . . . ED is one of the most common male sexual health problems, particularly in men aged over 40 years, and its prevalence increases as men get older. Up to 52 percent of men aged between 40 and 70 years will experience some degree of ED in their lifetime.³ Embarrassed to discuss the matter with their GP and uncertain how it could possibly be treated, many men had suffered from ED in silence for years without seeking advice. That was until they began to hear about Viagra®, and some of the stigma around discussing the condition began to be removed. Pfizer has worked hard to build the profile of Viagra® and to help both patients and healthcare professionals overcome their reticence to discuss sexual health matters. Pfizer has sponsored a number of health care initiatives, including a campaign during the 2002 football World Cup featuring ED spokesperson Pelé, screening programmes for men during Men’s Health Week, and a nurse education programme, accredited by the Royal College of Nursing called NEED (Nurse Education in Erectile Dysfunction). This programme aims to train nurses across the healthcare sector on the causes and diagnosis of ED. The programme also supports nurses in helping them to establish the most constructive way to talk about ED with men and their partners. Gavin Gandy, Marketing Manager for Viagra® says, “It has taken a long time to get people to overcome their embarrassment. On average it takes two years for a man to present his symptoms to his GP. Men are notoriously poor at accessing health care services; this is particularly true if the problem is of a sensitive nature.” Pfizer’s strategy has obviously worked in making Viagra® a household name. Ultimately it has achieved superbrand status. Gavin Gandy gives us one definition of a superbrand: “One that has established the finest reputation in its field. It offers customers significant emotional and tangible advantages over the competition, be it consciously or unconsciously.” The Role of the Representative Philip Watts, Sales Director at Pfizer told us: “It is particularly vital with a product like Viagra® that our representatives behave in a highly professional way, and with a real sense of pride in the therapy. We need to understand that erectile dysfunction is an embarrassing condition both for patients and in some cases even doctors. Right from the beginning we have encouraged our team to feel extremely proud of the difference that Viagra® can make to the lives of patients. Professionalism means “knowing your stuff” and presenting it to your customer in an appropriate, knowledgeable and confident manner. If you are able to do this, as well as showing pride for what you are doing, I am convinced that our brand will be the first choice of our customers.” This notion of pride certainly seems to have filtered down through the sales force. We noticed a genuine feeling of passion when talking to anyone involved in the selling or marketing of Viagra®. It is clear that they recognise their personal contributions: making a real difference to peoples’ lives, not only for the patients but also for their partners and loved ones. We spoke to two representatives who told us what it is like to be part of the superbrand’s team:

Irene Stone

Irene Stone, a representative with the Becket Primary Care Team, was with Pfizer for the launch of Viagra®. Irene says the product does not necessarily open all doors, or sell itself, despite its fame. She told us, “Because Viagra® is so well known, a lot of doctors say they know all about it and that there is no need to give them any more information. This is my opportunity to bring the brand to life, for instance by discussing an emerging news story about the product, of which there are many, and/or the varied benefits of the product. This product is the market leader. I have 100% confidence in the brand and I am 100% committed to selling it.”

Claire Das, who has sold Viagra® in hospitals for over four years, finds the fame of the product can really be a double-edged sword. “Obviously in the early days it was a fantastic opportunity to gain access to doctors as everyone wanted to talk about it. But there are misconceptions that people hold about Viagra®, often because the media coverage has been so extensive that customers think they already know all there is to know about it. Sometimes this is a smokescreen to avoid talking about ED, either because they are embarrassed, or possibly because they want to cover up their lack of knowledge about the subject. It is then very important to put them at ease and open them up to a frank discussion. It is hard to say whether it is Viagra®’s notoriety that makes it a motivating product to sell, or just the fact that it is such a life-changing product.” Claire continues, “Despite new competition in the past two years, Viagra® is still commanding market leader position by some distance. The fact that there is now competition in the market has allowed the representatives to really focus on the benefits of Viagra®. We can explain why Viagra® is the standard by which ED treatments are judged; this is a source of great pride.”

Claire Das

So What Has Contributed to Such a Motivated Sales Force? Philip Watts explained: “Much of this comes from the success stories that we hear, both from patients and doctors. I especially like it when doctors show our representatives the cards and letters of thanks that they have been sent by their patients. That’s what we are about in this industry – making people’s lives better – and that’s very motivating. In addition, the whole buzz that surrounded the launch of Viagra® was like nothing I have experienced before or after. Fantastic!”

References 1 Drugs and Therapeutics Bulletin. Vol 42. No 7 July 2004. 2 Padma-Nathan H, Eardley I, Kloner RA et al. 4-year update on the safety of sildenafil citrate (Viagra®). Urology 2002(suppl2B); 67-90. 3 Feldman HA, Goldstein, I Hatzichristou DG, et al. Impotence and its medical and psychological correlates: results of the Massachusetts male ageing study. J Urol 1994;151:54-61.