The market for erectile dysfunction

The global market for potency drugs was worth USD 4,3 billion in 2021. And sales statistics show that demand is growing rapidly. In large markets in the western world, the number of drugs sold has increased by an average of 3% per quarter since 2018, which corresponds to a volume increase of 41% for the entire period of 2018-2021.

Survey by IQVIA 2021 covering the markets USA, Great Britain, Germany, France and the Nordic countries

Erectile dysfunction has several different underlying causes, including stress, chronic diseases and psychological disorders. Stress is estimated to be more common in Europe and North America. Diabetes is one of the chronic diseases that can cause erectile dysfunction and is an important factor behind the increase in erectile dysfunction in the population. Erectile dysfunction caused by type 2 diabetes is estimated to increase the prevalence by 1% per year until 2040. Globally, diagnosed depression increased by approximately 18% between 2005 and 2015 and the increase is expected to continue, thereby being a contributing factor to the increase in erectile dysfunction in the population.

Assessed prevalence of ED diagnosis or PDE5I prescription by age, study based on a sample of 19,833,939 men in the US based on real-world observational data (claims data from MarketScan® databases and electronic health records from Humedica® database. Study funded by Pfizer Inc.)
Arizton, 2018; UN, 2017; JP Mulhall, 2016


PDE5 inhibitors are prescription drugs available in several variants, of which Viagra developed by Pfizer, Cialis developed by Eli Lilly and Levitra developed by Bayer AG and GlaxoSmithKline are market leaders in drug development in the treatment of erectile dysfunction.

PDE-5 inhibitors are used when needed, ie the drug is to be taken 30-60 minutes before intercourse. Furthermore, they have a short duration of action of up to a maximum of 36 hours. All in all, this means that sex needs to be planned and that the natural spontaneity is lost. The mechanism of action of PDE5 inhibitors is dilation of the blood vessels in the erectile tissue of the penis, which leads to a stronger erection. However, the dilation of the blood vessels is not only limited to this area, so PDE5 inhibitors also affect blood vessels in other parts of the body.

Common side effects of PDE5 inhibitors include runny nose, headache, blushing, abdominal pain, back pain, indigestion, temporary visual impairment, fatigue and dizziness. They have also been reported to cause other major side effects, including severe drop in blood pressure. This means that PDE5 inhibitors are contraindicated in patients with cardiovascular disease and in patients treated with nitro-drugs. Furthermore, up to 30 to 40% of patients with erection problems do not respond to treatment with this substance.

Park NC, Kim TN, Park HJ. Treatment Strategy for NonResponders to PDE5 Inhibitor. World J Mens Health. 2013 Apr; 31(1): 31–35.
Jackson G, Rosen RC, Kloner RA, Kostis JB. The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med. 2006 Jan;3(1):28-36;
Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS, Simonsen U, Uckert S, Wespes E, Andersson KE, Lue

Summary of important competitors

Viagra. PDE5 inhibitor. First on the market, ”the golden standard". Global registration.

Cialis. PDE5 inhibitor. Today higher sale volumes than Viagra. Global registration.

Limitations with current therapeutics

  • 30 to 40% of patients experience little or no effect, which also affects 70% of diabetic patients
  • Side effects such as nausea, headache, dizziness and drop in blood pressure
  • Short duration of action, which requires unwanted planning of sexual activity