When The Going Gets Tough…

As boomers age, more drugs are sold for bladder woes and other unmentionables

If you have sat through a string of drug ads on TV recently, you've probably heard a lot about "going" problems. One ad gently asks if you are always waking up to go. Another suggests that you have to go urgently, but once you get there you find you can't go at all. You're not imagining it: In 2006 pharmaceutical companies poured $238.8 million into ads for drugs to treat those embarrassing symptoms, including Flomax for prostate trouble and Vesicare for bladder issues. That's 37% more than the industry spent pitching such drugs in 2005, according to TNS Media Intelligence.

Don't expect the ad stream to slow anytime soon. The frequent urges that used to be considered a natural by-product of aging have become the drug industry's disease du jour. Novartis (NVS ) and Procter & Gamble Co. (PG ) recently kicked off a campaign for Enablex, a drug to treat overactive bladder. The TV ad features animated water balloons representing, well, you know. Boehringer Ingelheim, which makes Flomax, introduced its latest ad during the Super Bowl. It depicts four cycling and kayaking baby boomers looking happy, one assumes, because they don't have to find a restroom.

The ad assault is working. Prescriptions for Flomax were up 20% in 2006, according to IMS Health. Prescriptions for Glaxo-SmithKline PLC's (GSK ) Vesicare--its ads feature animated pipes that represent faulty plumbing--were up 212%, while Glaxo's prostate drug, Avodart, surged 94%. Total sales of drugs to treat bladder and prostate issues are $1.5 billion and $4 billion a year respectively, and growing at double-digit rates.

Pfizer Inc. (PFE ) might launch a new drug for overactive bladder later this year, and its approach will be closely watched. It was Pfizer that first implored TV viewers to talk to their doctors about touchy symptoms when it launched Viagra in 1998, bringing the term "erectile dysfunction" into everyday banter. Then there was Detrol, the bladder remedy Pfizer marketed with a jingle that went, "Gotta go, gotta go, gotta go right now." Although the ad was lampooned by comedians, Detrol became a $1 billion hit.

Some drug industry critics say the real "growing problem," to quote the Avodart ad, is not America's need to go. Rather, it's the relentless pressure drugmakers place on boomers to take more pills. Often such symptoms are nothing more than a nuisance of aging. "As men get older, their prostates get larger. They also go bald," says Michael Palese, assistant professor of urology at Mt. Sinai School of Medicine in New York. The ad blitz, he says "is irresponsible."


Jeff Huth, senior vice-president for marketing at Boehringer, says he and his colleagues debated the value of direct-to-consumer advertising for Flomax. In the end, they couldn't ignore the statistics: Half of all men over age 50, or about 20 million men in the U.S., have the condition the drug treats, enlarged prostate. Because they have to get up frequently at night, they often suffer sleep deprivation, Huth points out. But less than 15% of them are being treated. "Many men are suffering in silence," Huth says. "The ads help them recognize this is a treatable condition."

Execs at P&G hope the water-balloon image for a misbehaving bladder will make its drug Enablex stand out in a crowded field of ads employing "gotta go" euphemisms. And they defend direct-to-consumer marketing as an important way to make people more comfortable talking about taboo topics. About 17 million men and women in the U.S. have bladder problems. "Incontinence is embarrassing and has emotional consequences," says spokeswoman Elaine Plummer. "This is a lighthearted way to open the discussion." Some doctors also say the ads are driving more people to seek medical advice, leading to earlier detection of serious problems such as cancer or blockages that need to be fixed with surgery.

The debate is bound to get noisier, judging from the number of new gotta-go drugs in development. Allergan Inc., for example, is testing Botox to treat overactive bladder. And scientists are experimenting with mixtures of drugs that are already on the market. If they work, companies will be able to patent the combos as new drugs. You know what that means: more pipe people, balloons, and no-longer-embarrassed boomers will be parading across our TV screens.

By Arlene Weintraub

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