I’ve said it before and I’ll say it again, I think Big Pharma has overpathologized and overmedicalized male sexuality. For example, have you seen the following ads in your social media feeds?
The modern version of early 2000s Viagra commercials, these ads for online prescription-based men's health apps are everywhere. Why? Because there’s a lot of money to be made. The global erectile dysfunction drugs market was valued at 2.3 billion US dollars in 2021 and is expected to expand at a compounded annual growth rate of 8.5% from 2022 to 2030.
You might already know that Pfizer, a household Big Pharma name, has a near monopoly on the Erectile dysfunction drugs market, making $400m three months after the launch of the “little blue pill” in 1998 and consistently generating annual sales to the tune of $1.8bn. Making Viagra the fastest selling drug in history.
What you mightn’t know is that the pharmaceutical giant’s remaining patents on viagra expired in 2020, which immediately resulted in a whole host of generic versions of the drug emerging as other manufacturers jostled for a piece of the pie.
This is one precipitating factor for the proliferation of men’s health apps. The other being the rise of Telehealth services. And the catalyst that supercharged this up was Covid.
Telehealth has a history dating back to the 90s mainly to deliver healthcare to patients in remote areas, but the pandemic led to a significant increase in the use of telehealth services in Australia, with the government introducing temporary measures in 2020 to make it easier for patients to access these services from home. Then in 2021, Telehealth became a permanent feature of primary health care, with the government investing another $308.6m in Telehealth services.
While this funding was promoted as helping deliver healthcare via video and telephone consultations, the Australian Health Practitioner Regulation Agency defines Telehealth as “healthcare delivery or related activities that use any form of technology as an alternative to face-to-face consultations.”
This is why you’ll see all these ads saying how easy it is to get your hands on Erectile dysfunction medication, which you actually need a prescription for here in Australia, a measure that was actually introduced to restrict the sale and distribution of this medication. But these measures are rendered almost meaningless when you consider how men are being screened for ED now. You simply complete an online questionnaire in the app, which is supposedly reviewed by a doctor, thus acting as a “consultation,” and you receive your prescription to purchase ED medication through the very same app via a pharmacy they’ve conveniently partnered with.
How do I know this? Because I did it. I lied on the questionnaire, paid my money for a “consultation,” which seemingly just involved a doctor looking at my questionnaire results and saying “Yep, you’re a good candidate for an ED prescription.” They wrote me one, I paid some more money, and boom, the drugs arrived at my door.
And I probably wasn’t the only person who did this, as sales of ED medications increased 67% from February 2020 to December 2020. Statistics like this have led to physicians expressing concern about the increasing recreational use of Erectile dysfunction medication, especially in younger men.
The doctors affiliated with these apps generally get paid per consultation, regardless of the outcome of the consultation. But, of course, you need to have several consultations over the period of time that you’re taking ED medication, so there is a financial incentive to write a prescription.
In my opinion, this raises serious concerns about the influence of the pharmaceutical industry's aggressive direct to consumer advertising of erectile dysfunction medication. Especially the medicalizing of a condition that has strong psychosocial origins and manifestations.
I think a lot of physicians - and folks in general - have internalized the message of the pharmaceutical industry and do not question the value of erectile dysfunction medication nor the motives of big pharma. My vision for the future is that we begin treating male sexuality more holistically and consider men as human beings, not malfunctioning machines that need a quick fix in the form of a pill.