Viagra at 20: The diamond-shaped blue pill that revolutionised sex

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Viagra, the little blue pill that treats impotence, celebrates its 20th anniversary on Tuesday. The drug has sold in the billions, unleashed a cultural shift across the globe and made sex possible again for millions of older men.

The diamond-shaped blue pill was initially developed to treat high-blood pressure and chest pain, but quickly showed an unexpected side-effect during clinical trials: combating erectile dysfunction.

On a strictly technical level, the PDE5 inhibitors cause the dilation of the blood vessels around the penis, thus facilitating blood circulation. Twenty years later, nothing else has proven to be as effective.

However, despite this success, the company behind the drug — Pfizer — is wrestling with declining sales.

Global sales were at $1.2 billion (£850m) in 2017, down by nearly half on $2.1 billion five years earlier.

A third of men over 40 suffer from erectile dysfunction, according to a study published in European Urology in 2002. But Pfizer estimates that men in many countries, with one example being the UK, do not seek treatment. In a bid to boost sales, in 2017 the drug was made available without a prescription in the UK — the first country to grant Viagra over-the-counter status.

Viagra in numbers:

  • 150,000: In the first two weeks of the drug going on sale, 150,000 prescriptions are written in the US.
  • 65 million: In 20 years, 65 million prescriptions of Viagra have been written worldwide.
  • 37 million: Between 1998 and 2013, 37 million men consumed Viagra, according to Challenges magazine.
  • From $15 to $1: A single Viagra tablet was originally sold at $15 (a little over €12). The price then rose to $50 (€40) before falling back to $1 in 2017 with the release of a generic version in the USA. In Europe, where the first generics appeared in 2013, the average price of a tablet is €10.
  • 27 minutes: This is the average time the drugs take to have an effect.
  • 80: Percentage of Viagra randomly bought online is fake.
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