What happens when lifestyle drugs like Viagra and Cialis lose patent protections?

Each year, millions of men rely on pharmaceuticals like Viagra and Cialis for their erectile dysfunction (ED), but they may not be the only ones facing dysfunctionalities.  As the patents on these lucrative lifestyle drugs come to an end, price tags and bottom lines are expected to plummet.

PDE5 Inhibitors

Viagra made by Pfizer and Cialis by Eli Lilly are phosphodiesterase type 5 (PDE5) inhibitors which break down cyclic guanosine monophosphate (cGMP).  In a gross simplification, after sexual stimulation, an erection occurs through the release of nitric oxide (NO) which causes dilation of blood vessels due to an accumulation of (cGMP).  Dysfunction occurs when cGMP conflicts with the NO vasodilatory effects. When the PDE5 inhibitor is introduced, the cGMP is broken down.  So, less cGMP means more blood flow et voilà, an erection.

There are differences between these drugs, though.  For example, Viagra is made with sildenafil and has a wait time of 30-60 minutes lasting for up to 4 hours. Cialis’ main ingredient is tadalafil and can either be taken daily (meaning it is always active in the body) or 30 minutes to 12 hours before activity to last up to 36 hours. This longer lasting formula is one of the benefits over the “little blue pill” which has proved to be more appealing to most men.  Further, sildenafil and tadalafil have different chemical and molecular structures.

Viagra and Cialis Patent Protection

The success of these drugs has been guaranteed in large part by securing IP rights across the globe.  Viagra was approved by the FDA in the United States in 1998 and Cialis in 2003, but their patent journeys occurred earlier.

The first patent for Viagra was filed in May 1994and was issued in 2002, but Viagra did not begin as an ED pill.   The compound was originally developed and patented as a drug called Revatio to treat high blood pressure (hypertension) and chest pain due to heart disease (angina pectoris), but clinical trials showed that it was more effective at inducing erections than anything else.

The drug was then renamed and patented as Viagra. Viagra was a pre-GATT application because it was filed before June 8, 1995, so it got the benefit of choosing its expiration date: either 17 years from the issue date of 2002, that is to say October 2019 or 20 years from filing, with rights lapsing in May 2014.  Naturally, Pfizer selected the later October 2019 date.  Further, through the FDA, the expiration was extended another 6 months to April 2020 due to a special pediatric exclusivity testing Revatio’s effect on pulmonary arterial hypertension.

With the expiration of Viagra three years away, you would think that the market for generics would be on hold until then.  However, an Israeli manufacturer named Teva Pharmaceutical Industries Ltd. will be allowed to sell a generic version of Viagra beginning December 11, 2017. Since several patents outside the US have already expired, an undisclosed deal was arranged after Pfizer sued Teva and Teva was authorized to launch a generic version.  The settlement stipulates that the generic manufacturer will have to pay royalties to Pfizer through the April 2020 patent expiration date. Teva’s inventory has already been approved by the FDA for three different strengths of sildenafil citrate and the company has been selling a generic in the European Union since 2013.

Cialis came to market after an over five-year monopoly of Viagra as the only prescription drug on the market to treat ED.  In its first year, Viagra sales revenue exceeded $1 billion, but its profit margins declined with the introduction and FDA approval of Levitra (another ED antidote) in August 2003 and Cialis in November 2003.  Cialis was discovered in August 1991 by a company named Icos and was later purchased by Eli Lilly. Patent protection expires at the end of this year, so the company will still be able to register a profit during almost the entirety of 2017 before getting crushed by generics.

Like Viagra, Cialis is also used to treat pulmonary arterial hypertension and was approved as such in the US in May 2009.  Another similarity is that Eli Lilly struck a licensing deal with the French company Sanofi to maximize any profits it possibly can before the patent expires.  In 2014, an announcement of this licensing agreement was made where Sanofi will sell an over-the-counter version of Cialis in the U.S., Europe, Canada and Australia when specific patents expire.  Lilly will make its money through the licensing fees.

Another way Pfizer and Eli Lilly have tried to recoup lost sales is by making the drugs over-the-counter medications and selling them directly through their websites.  By doing this, the companies goals are to capture sales from those who are too embarrassed by the social stigma of impotence and who do not want to discuss their condition with a doctor.

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Lifestyle vs. Lifesaving Drugs

Viagra and Cialis are lifestyle drugs.  This label means that they treat “lifestyle illnesses” arising from lifestyle choices like smoking, weight gain, and alcoholism or ailments like baldness, dry skin, wrinkles, ED and hot flashes.  These medicines may improve a patient’s life, function or appearance and may not be medically necessary or therapeutic. One way to look at them is that they enhance a patient’s life instead of extending it. These are unlike life-saving pharmaceuticals used to cure or manage illness and generally improve health, like cancer or HIV medications.  The good news for ED drugs is that they are reasonably secure in their patents under Trade-Related Aspects of Intellectual Property Rights Agreement (TRIPS).  It is less likely that countries facing major pandemics like HIV/AIDS, malaria and Zika will be too concerned with needing lower priced drugs for ED, weight loss or crow’s feet, unless the drugs have other, more relevant, implications.

The lifestyle drug market is extremely lucrative. These medications can be used by all age groups worldwide and increased individual awareness of health and beauty has created a demand for physical fitness and improved performance of all our body parts.  People are living longer, have higher disposable income, and the demand only grows more when a drug touts the high quality and safety of their formulations after it passes the stringent requirements for FDA approval. Additionally, a greater number of people are turning to pharmaceuticals to “treat” ordinary ailments, mild symptoms and personal problems, thinking that a pill is the answer to all their problems. Also good for the Pfizers and Eli Lillys of the world is that since the pharmaceuticals are not curing a disease or problem, but rather treating an issue (such as ED, cholesterol or high blood pressure) the patient takes daily doses and usually over many years.  This is unlike an antibiotic that is taking for a finite duration and once the taker is cured they no longer need the drugs, effecting that medicines bottom line.

Further, since lifestyle drugs have a better shot at being successful economically because they can be sold to more people, drug companies are more likely to continue to create and invest in those rather than medicines for, say, malaria, where the patients are fewer and too poor to pay enough to offset the sky-high R&D costs.

Conclusion

Lifestyle drugs like Viagra and Cialis have been an extraordinary success for drug companies for many years. It will be difficult to replace the revenue of these blockbuster drugs once they go off patent in the United States, but when that happens consumers can expect generics to race into the marketplace and for prices to fall. The real question, however, is whether U.S. patent law and policy will continue to give pharmaceutical companies the incentives necessary to innovate lifesaving medicines, or whether we will continue to see more and more blockbuster lifestyle drugs moving into the future.

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Join the Discussion

19 comments so far.

  • [Avatar for David L Taylor]
    David L Taylor
    August 7, 2017 07:18 am

    As to the cost and value of products made in the United States vs else where in my opinion the cost in the United States is so high a lot of people can not afford it any way where the prices for drugs arr what ever a drug company wants to charge due to the fact that in our country you have finance political campaigns with money from big companies. So who do you really think your congressman and senator work for? You?

  • [Avatar for David L Taylor]
    David L Taylor
    August 7, 2017 07:10 am

    I do not want to shock anyone here, but as far as i know the U.S. is the only country in the world that does NOT regular drug prices.

  • [Avatar for Arthur Eddy]
    Arthur Eddy
    August 1, 2017 04:59 pm

    BG, I am a retired dentist, out of the game now. If I were getting crowns manufactured in the US and delivered in Mexico for $120 I would be shocked or worried. It may not be the truth. Ask to see the lab prescription to verify materials and place of construction. Back when I was practicing I was paying lab fees from national competitive labs that were $180+++ a couple of years ago. There are crowns with real gold, semi precious gold, and no gold. You had better ask more questions and more thorough questions before you start comparing products for Global Medical Tourism. Is your facility meeting CDC requirements? Did the patient before you have AIDS, hepatitis, STD, cancer, etc? If so, who is protecting you? Is the person licensed and what is the standard? Is the staff adequately licensed? If you acquire a life long disease or damages what is your course of addressing them?Are they using Universal Precautions? Are they using steam autoclave sterilization? With spore testing for certification? What is the quality of the cementation.
    What seems to be apples to apples may not be. We hire non American trained dentists to treat our Medicaid (welfare) patients in our state to provide low cost care. The range of capabilities is staggering from foreign dental school to school. Some are fine some we have to send home.
    Remember the adage, “Long after the sweetness of price disappears, there remains the bitter after taste of quality.
    I hope things work out for you with safe and long term health and function but things may not be exactly as you wish they may be without the same protections, training, and governmental oversight.

  • [Avatar for BG]
    BG
    July 21, 2017 01:49 pm

    Gene is right. Most health insurance plans do not cover the cost of these overpriced drugs. Those that do will only cover the cost of 5 doses per month typically. Our insurance comes through my wife’s employer and her company has been bought out several times since she has had her job and each time we have had a different insurance provider. None covered the cost if ED meds. She’s a nurse and has good insurance. It’s just not common anymore for insurance to cover these drugs because they are so expensive. They just keep raising the prices. A ten dollar pill is now $35. It was cost prohibitive for insurance companies and employers who pay for part of the insurance. We get ours in Mexico for a fraction of what they cost here and also get our major dental work done there because it is cheaper to make the trip there than do the work here even with insurance, and these are great facilities and great English speaking professionals who do fantastic work. Permanent crowns are actually made in the USA and sent back to Mexico, $120 per crown compared to $900 at home. Blows me away how badly we are ripped off by the entire healthcare/dental/pharmaceutical industry in this country.

  • [Avatar for Whatisthis]
    Whatisthis
    July 20, 2017 04:21 pm

    Gene, that isn’t correct. Insurance does cover cost of ED drugs.

  • [Avatar for Gene Quinn]
    Gene Quinn
    July 11, 2017 11:22 pm

    Jim Demers-

    Whether insurance should pay for ED drugs maybe an interesting philosophical conversation, it is my understanding that insurance does not cover ED drugs.

    -Gene

  • [Avatar for Jim Demers]
    Jim Demers
    July 11, 2017 03:51 pm

    Alcoholism is a “lifestylle choice”?
    The article makes some pertinent observations, but there’s nothing here we didn’t already know. To the extent that making billions off of treatments for ED (and, in the future, perhaps baldness and wrinkles) helps fund the development of antibiotics and antimalarials, lifestyle drugs are a very good thing.
    The conclusion misses the really important “big question”, which is whether health insurance (and national health plans in particular) should pay for them. Contraceptives, in the long run, save an insurance comany money, while ED drugs arguably do the opposite. (Now there’s a topic for discussion!)

  • [Avatar for William]
    William
    June 5, 2017 04:14 am

    When will these generics hit the stores????

  • [Avatar for TG]
    TG
    May 25, 2017 03:58 pm

    There is an elephant in the room here.

    Currently there are three essentially similar drugs for treating ED. They all have enormous markups, and all sell for almost exactly the same price per dose.

    Obviously the big drug companies are colluding, and agreeing in private not to undercut each other’s prices.

    Why is this obvious fact NEVER mentioned? At least, I’ve never seen it mentioned in any mainstream news source.

    What happened to capitalism encouraging competition and producing goods more efficiently and cheaply? Are secret anti-competitive agreements and inflating prices for what already exists how our new improved neoliberal variant of ‘capitalism’ works?

  • [Avatar for Caesar Salazar]
    Caesar Salazar
    April 14, 2017 04:05 pm

    I was simply pointing out what American Cowboy was saying with an example. Calling treatments for those that suffer from what society has labeled “lifestyle problems” is in a way criticizing innovation itself. All of our problems are “lifestyle” problems. Is medication for severe acne or eczema not worthy since it’s “not medically necessary?” I was simply pointing out that people who make these statements often dismiss those with perceived “lifestyle” ailments until they themselves are hit with them. It’s a weird form of victim blaming. Some of the greatest innovations came from “lifestyle” things. By calling them “lifestyle” one is almost pre-empting the field.

  • [Avatar for Gene Quinn]
    Gene Quinn
    April 13, 2017 11:27 am

    Ralph-

    Sorry you don’t understand the article. Obviously, the article is not clickbait. It discusses an important topic. Perhaps rather than jumping to erroneous conclusions you should actually read the article and inform yourself.

    -Gene

  • [Avatar for Gene Quinn]
    Gene Quinn
    April 13, 2017 11:26 am

    Caesar-

    It is inappropriate to make a comment about the looks of an author, period. If you want to participate in discussion keep it substantive or you will be gone.

    As for this being a weird topic, I’m sorry you don’t understand that significance of the article. I guess you didn’t read to the end. Too bad for you.

    -Gene

  • [Avatar for Caesar Salazar]
    Caesar Salazar
    April 13, 2017 11:05 am

    COMMENT DELETED by GQ.

  • [Avatar for American Cowboy]
    American Cowboy
    April 13, 2017 09:42 am

    I get the impression that the author disapproves of people having improved lifestyles. Commissars thought that way too.

  • [Avatar for Ralph]
    Ralph
    April 13, 2017 09:08 am

    Clickbait.

  • [Avatar for Peter R Kramer, Ph. D.]
    Peter R Kramer, Ph. D.
    April 13, 2017 03:47 am

    “Viagra made by Pfizer and Cialis by Eli Lilly are phosphodiesterase type 5 (PDE5) inhibitors which break down cyclic guanosine monophosphate (cGMP).” This shoud be changed to:
    Viagra made by Pfizer and Cialis by Eli Lilly are phosphodiesterase type 5 (PDE5) inhibitors which INHIBIT THE break down cyclic guanosine monophosphate (cGMP).
    ———————-
    Also another correction,
    “When the PDE5 inhibitor is introduced, the cGMP is broken down AT A SLOWER RATE. So, [[less]] MORE cGMP means more blood flow et voilà, an erection.”

  • [Avatar for Caesar Salazar]
    Caesar Salazar
    April 12, 2017 01:21 pm

    What a weird article topic…

  • [Avatar for angry dude]
    angry dude
    April 12, 2017 01:18 pm

    The correct question to ask is this:

    Will we have any new drugs at all if pharmaceutical patents are substantially weakened or abolished ?

    After all, it is easy and cheap for copycats to analyse and re-synthesize any chemical substance, and it takes years or even decades of expensive R&D and more years for FDA trials and approvals to get it to market in the first place

    So far the US has been bearing the cost of new drug discovery with the rest of the world enjoying copycat products at substantially cheaper prices

  • [Avatar for Anon2]
    Anon2
    April 12, 2017 11:44 am

    Excellent article.