Brands and cultural context

Gianfranco Salvi
Head of Strategy & Business
Development Director
Kantar Health

Lessons from the success of Viagra and Cialis

In prescription pharmaceuticals, the role of brand differs from other product categories mainly because the relationship with the consumer is mediated by a doctor, and because there is rarely an opportunity to advertise. Under such conditions, it is very difficult for a drug to reach the popularity and evocative power of an iPhone, for instance. But sometimes it happens.

For almost 20 years, the word “Viagra” has been used to mean “erectile dysfunction drug”, despite the fact there are now many such drugs, and for several years the market leader in Italy and globally has been Cialis, a brand which is certainly very well-known, but not as deeply ingrained in the collective mind as Viagra.

Of course, having been the first oral medication for erectile dysfunction has played a crucial role in granting the “little blue pill” the status of icon. However, this makes the success of Cialis particularly interesting, as it was achieved during a period of rapid change in how this issue was discussed, particularly in Italy.

At the end of the 1990s, when Viagra was launched, erectile dysfunction “did not exist”, in the sense that very few people understood the meaning of the term. In order to be understood, you had to speak of “sexual impotence”, but this was difficult as men felt totally uncomfortable discussing it. Conducting market research on “impotent” patients was a challenging task: samples were very limited despite the fact that the disorder is widespread, and it took interviewers with special skills to manage psychological barriers during questioning. There were situations in which patients burst into tears during interviews, revealing that it was the first time they had spoken of their problem despite years of suffering.

In fact, erectile dysfunction was implicitly perceived as an indelible, unmentionable stigma; those suffering from it were seen as lost, damned souls, forced to hide their condition, not least because there was no real solution for them.

The prospect of marketing Viagra suddenly opened a gap in this silent abyss. A condition that had always been treated and discussed exclusively in private suddenly became an extraordinary public phenomenon. Through the anonymity of TV, talk shows were registering shares equivalent to a Champions League final every time they spoke of the new “miraculous” product, and that wave of cheerful enthusiasm spread to everyone: the sick, the insecure, the ambitious and the simply curious alike. The boundaries between normality and pathology were thus entirely removed, and the Viagra brand became the collective symbol of guaranteed sexual power for all men.

This is precisely what then revealed itself as the limit of the blue pill, which exploited but was also hampered by the sociocultural context of the time. The popularity of Viagra did not allow the company to drive sales as it might have done, despite the fact that the potential market was enormous, and it was substantially a monopoly.

The doctor often became a sort of “bottleneck”, an obstacle that forced one to discuss, with embarrassment and euphemisms, one’s difficulties in order to obtain a prescription. It is not by chance that for a long time, sales were limited: the Viagra phenomenon had become a very public discussion, but you still had to face the doctor by yourself.

When Cialis made its appearance on the market, it was not faced with a competitor, but a true institution that polarized through its brand everything linked to sexual performance. Under these conditions, it was complicated to conquer large shares of patients, made more complicated because the pharmacological characteristics of the Lilly product were not obviously advantageous. If Cialis overturned the sector equilibrium in the space of a few years, it is because the company interpreted the needs and trends of the time in the best of ways, merging them in its favor.

This was done firstly by concentrating activities on the role of the specialist, who had almost been excluded from the “Viagra hurricane”, and returning to specialists their primary role of competence on what is at any rate a male urogenital disorder.

But it was mainly done by putting couples at the centre of the discussion. The world of Viagra, which was one-dimensional and aimed at a great performance, was essentially male. The woman had a secondary role, which was passive and not necessarily relational. And perhaps it could not have been otherwise during the times described above, in which a patient’s only need was that of achieving a consistent erection.

The importance of life as a couple and the celebration of carefree domestic relations were the ingredients that led to the success of “the weekend pill”, transforming a potential problem into a value that was really meeting the needs of many people who in the meantime had become more knowledgeable on a topic which had itself become less dramatic.

Currently, Cialis and Viagra share the majority of a satisfied and crowded market. A brand wishing to try to impose itself must take into account, alongside the fierce competition, a sociocultural context that has changed considerably. Nowadays, “erectile dysfunction” is a term understood by everyone and very few people giggle or feel uncomfortable when it is mentioned. At the bar you can hear older people arguing over whether Viagra or Cialis is better; 20 years may have passed, but this is indeed a new millennium.