Barco projection systems case answers

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MKTG−UB.55 Tulin Erdem New York University Fall 2015

MKTG−UB.55, Erdem, Fall 2015 New York University

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MKTG−UB.55, Erdem, Fall 2015 Table of Contents

“Product Team Cialis: Getting Ready to Market. Color Case” by Ofek, Elie XanEdu Extra

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“Barco Projection Systems (A): Worldwide Niche Marketing” by Moriarty, Rowland T., Jr.; McQuade, Krista

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“Omnitel Pronto Italia” by Lal, Rajiv; Knoop, Carin−Isabel; Raju, Suma XanEdu Extra

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“U.S. Retail Coffee Market (A)” by Yip, George S.; Williams, Jeffrey R. XanEdu Extra

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“Ontela PicDeck (A): Customer Segmentation, Targeting, and Positioning” by Sawhney, Mohanbir; Grayson, Kent; Duprss, Patrick; Hsu, Christine; Metzger, Ryan; Obuchi, Fuminari; Sundaram, Arum; Wilson, Kari

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“Ontela PicDeck (B): Customer Segmentation, Targeting, and Positioning” by Sawhney, Mohanbir; Grayson, Kent; Duprss, Patrick; Hsu, Christine; Metzger, Ryan; Obuchi, Fuminari; Sundaram, Arum; Wilson, Kari

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“Burberry. Color Case” by Moon, Youngme XanEdu Extra

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“Biopure Corp.” by Gourville, John T. XanEdu Extra

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“Coca−Cola's New Vending Machine (A): Pricing to Capture Value, or Not?” by King, Charles; Narayandas, Das

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“Dove: Evolution of a Brand” by Deighton, John XanEdu Extra

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“Cunard Line Ltd.: Managing Integrated Marketing Communications” by Greyser, Stephen A.; Young, Robert F.

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“Hewlett−Packard Imaging Systems Division: Sonos 100 C/F Introduction” by Cespedes, Frank V.; Bell, Marie

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“Samsung Electronics Co.: Global Marketing Operations” by Quelch, John A.; Harrington, Anna

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ELIE OFEK

HARVARD BUSINESS SCHOOL

9-505-038 REV: JULY 28, 2010

Product Team Cialis: Getting Ready to Market

It was early 2002, and Mark Barbato, the executive director and global product team leader for Cialis, knew he faced a daunting task: launching a medicine for the treatment of male impotence in a market with an established leader-Viagra.l Not only had Viagra been generating over $1 billion in sales annually for its parent company Pfizer for three consecutive years, but it also enjoyed the highest brand recognition of any other pharmaceutical drug in the world.

Despite the huge success of Viagra, Barbato and his team were very optimistic about the future prospects for Cialis (active ingredient is tadalafil). The innovative new drug, developed through a joint venture (Lilly ICaS LLC) between Eli Lilly, the pharmaceutical giant, and ICaS, a young biotech upstart, showed promising clinical results. At an upcoming prestigious urology conference, to be held in the spring of 2002, medical investigators would present data showing that a 20mg oral dose of Cialis improved the ability of up to 81% of men suffering from male impotence to respond to sexual stimulation over an extended period of time, even 36 hours after taking the drug. Since Viagra's effect lasts approximately four hours after dosing, the new treatment offered such men a significantly greater window of opportunity to choose the right moment of intimacy. Furthermore, the body's ability to absorb Viagra was diminished when the drug was taken during or after a high-fat meal, potentially leading to slower onset time.2 In contrast, the absorption of Cialis was not affected by food intake. Cialis demonstrated a generally favorable safety profile, similar to that seen with Viagra. Both drugs were not to be taken in conjunction with nitrates, which may be given to treat select heart problems. The incidence of visual irregularities, a side effect of Viagra, was notably rare for Cialis.3

Following Cialis's successful phase III clinical trials, a new-drug application (NDA) was submitted to the U.s. Food and Drug Administration (FDA) on June 28, 2001, and a similar application was filed in July with the European Agency for the Evaluation of Medicinal Products. With the approval process taking an average 12-18 months in both jurisdictions, the Lilly ICaS LLC board members, comprising both Lilly and ICaS top management, were hoping for a launch in 2002. In preparation for the launch, a brand council was scheduled for January 18. The brand council would bring together top Lilly marketing representatives from around the world, all eager to learn how Cialis would be differentiated from the competition and how they should promote the new drug once it was approved. With the meeting less than two weeks away, the global marketing director for the Cialis product team, Rob Brown (from Lilly), and Leonard Blum, vice president of sales and marketing at ICaS, had their work cut out for them. They had to come up with a strategy that would guide all

1 Cialis is a trademark of Lilly ICOS LLC. Viagra is a trademark of Pfizer, Inc.

2 Lower peak blood levels can also result. The regulatory guidelines used to determine the presence or absence of a food interaction (for package inserts/labels) are based on a very specifically defined high-fat meal.

3 "Giving Viagra a Run For Its Money," BusinessWeek, October 23, 2000.

Professor Elie Ofek prepared this case. HBS cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management.

Copyright © 2004, 2006, 2009, 2010 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-545-7685, write Harvard Business School Publishing, Boston, MA 02163, or go to http://www.hbsp.harvard.edu. No part of this publication may be reproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means-electronic, mechanical, photocopying, recording, or otherwise-without the permission of Harvard Business School.

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future marketing activity. In particular, they had to clearly identify a target market for the drug and a way to position it against the competition. Brown and Blum were contemplating three possible approaches: Cialis could either follow a “niche” strategy, whereby a specific and relatively narrow segment would be identified and targeted; it could follow a direct “compete” strategy and go head- to-head with Viagra’s positioning; or it could follow a “beat” strategy and try to come up with a differentiated positioning that would allow it to pursue a broad market.

ED—A Treatable Medical Condition

When Pfizer created a little blue pill called Viagra, it produced a widely used oral treatment for a medical condition rarely discussed in public—male impotence, or erectile dysfunction (ED). For men who suffer from ED, the process by which increased blood can flow to tissue necessary for attaining an erection is impaired. Most cases of ED are associated with another medical disease, certain medications, or lifestyle factors such as smoking or excessive alcohol consumption. (Primary morbidities linked to ED are shown in Exhibit 1.) The nature and incidence of these diseases tend to produce a strong age correlate with the ED condition. As for psychological factors, such as stress and depression, experts believe they account for roughly 20% of ED cases. An estimated 30 million men in the United States and 150 million worldwide experience chronic ED. Furthermore, the National Institutes of Health estimates that as many as 50% of all men between the ages of 40 and 70 experience some form of ED.4

Viagra (active ingredient is sildenafil citrate) temporarily inhibits the phosphodiesterase type 5 (PDE5) enzyme that normally interferes with the increased blood-flow process necessary for attaining an erection. Viagra is a prescription medication, in the form of 25, 50, and 100mg tablets, that can be taken up to once daily. It has a 30-minute to one-hour onset time (time from taking the pill until it becomes effective) and requires sexual stimulation for it to produce an erection. Viagra’s half-life was three to five hours.5 Pfizer studies indicated that Viagra improves erection in approximately 80% of men who suffer from ED. Viagra is not safe to take with nitrates used to treat certain heart conditions and has a list of common side effects. These include facial flushing, headaches, indigestion, and blue- tinted vision. In the United States, Viagra costs around $10 per pill at retail (when no coverage from health insurance is provided).6

Viagra’s Launch

Viagra had a notably successful launch. A total of 600,000 prescriptions were filled in the first month (April 1998), and its brand name immediately became the common noun for the symptom it said it would treat—erectile dysfunction.7 Its recognition far transcended the circles of ED patients. It quickly mushroomed into a cultural phenomenon, becoming the subject of dinner-table conversations and late-night television comedy (see Exhibit 2 for examples of how Viagra was portrayed in popular magazines). When Pfizer introduced Viagra, it used Bob Dole, a 75-year-old, well-known former politician, to support Viagra on TV. The Bob Dole ads urged men with ED to have checkups. For many older people, Dole emerged as a hero who displayed a rare combination of 4 “Urology Channel,” Business Wire, May 21, 2001. 5 A drug’s half-life measures the time it takes for the drug’s concentration in the blood stream to reach exactly one-half of its initial concentration and is a common metric for the duration of effectiveness. Package inserts contained information on a drug’s half-life. 6 “The New Era of Lifestyle Drugs,” BusinessWeek, May 11, 1998. 7 BrandEra.com, from “How Viagra Revived After a Cold Shower,” BusinessWeek, August 20, 2000, http://www.brandera.com/ digests/00/08/23.

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determination, courage, and humor. In a 1998 interview on CNN’s “Larry King Live,” Dole revealed he had taken part in clinical trials for Viagra to treat the impotency resulting from the removal of his cancerous prostate in 1991.8

Six months after Viagra went on the market, however, things turned sour. The FDA received reports of 130 deaths of patients taking Viagra; over half of the incidents were cardiovascular related. Prescriptions plummeted immediately. Pfizer understood there had to be an orderly process to combat the legitimate safety fears. The first step was to retest the drug to assure policymakers and the public that Viagra would not place the user at risk. A follow-up study on Viagra’s safety was conducted in Sweden immediately after the controversy erupted. Patients with both cardiovascular disease and erectile dysfunction took the drug in a carefully controlled test. Viagra was effective, while the heart attack rate was no greater for its users or the control group that was given a placebo. Pfizer made a concerted effort to communicate these findings to key decision makers and experts in the medical community.9 Pfizer then rolled out a $53 million advertising blitz, and its sales force made close to 700,000 doctor visits to push the medication throughout 1999. The aggressive marketing turned around the downward spiral as sales that year topped $1 billion.

Developing the Next ED Drug

It all began when ICOS, a small biotech start-up based in Bothell, Washington, was trying to develop therapeutically useful inhibitors of the phosphodiesterase family of enzymes. To achieve this goal, ICOS teamed up with Glaxo Wellcome, a large pharmaceutical company based in the U.K. After a few years of codevelopment, several potentially valuable compounds materialized. However, in the mid-1990s, the collaboration ended, leaving each party free to pursue the research and development (R&D) of PDE inhibitors independently. One specific molecule under development at ICOS, designated IC351, represented a structurally novel class of PDE5 inhibitors and in initial phase II trials showed it was effective at improving erections in men suffering from ED (provided they were sexually stimulated). Early experiments also indicated an onset time of 30 minutes and a half-life of over 17 hours, significantly greater than that of Viagra. Furthermore, IC351 was chemically narrowly targeted on the PDE5 enzyme, and it did not significantly inhibit other PDE enzymes, particularly PDE6. It was believed that inhibition of this enzyme was the reason for Viagra’s blue-vision side effect. Encouraged by these results, ICOS initiated additional phase II clinical trials (see Exhibit 3 for a description of the required phases leading to FDA approval). ICOS management realized it was time to start thinking ahead. But while the company felt it had honed its R&D skills by this time, it had never taken any product to market. With no experience in FDA registration trials and no marketing capabilities, ICOS was once again in search of a partner.

The Lilly ICOS Joint Venture Initially, there was a temptation to enter a royalty agreement and simply hand off IC351 to

another company that would take full control of the final stages of testing and market launch. But George Rathmann, CEO of ICOS at the time, had a different objective in mind. With several other drugs in advanced stages of development and trials, he realized that if ICOS were ever to become a self-sufficient biotech company, it would need to possess its own clinical development and marketing capabilities. This called for finding a partner company that would be willing to work with ICOS in a collaborative joint venture, sharing responsibilities and involving ICOS personnel in key decision making. In the fall of 1998, after talks with several major pharmaceuticals, the ideal partner was found—Eli Lilly and Company. 8 Fred Brock, “A Dose of Sense from Viagra’s Spokesman,” The New York Times, June 4, 2000. 9 “How Viagra Revived After a Cold Shower,” BusinessWeek, August 28, 2000.

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At Lilly, forging successful partnerships with other firms was seen as a strategic capability worth cultivating. In the words of Sidney Taurel, chairman of the board, president, and CEO of Lilly: “Successful alliances are more critical than ever to our strategy. We are working hard to be recognized as the pharmaceutical industry's premier partner by consistently creating value for our partners and for Lilly.”10 The promising results IC351 had shown thus far, the committed management of ICOS, and its earnest desire to leverage Lilly resources made this a mutually attractive alliance. The Lilly ICOS LLC joint venture was signed on September 30, 1998, with a board of managers comprising four representatives from Lilly and four from ICOS. Profits from future sales of the drug in North America and Europe would be split 50/50 between the two companies.11 Soon after the signing of the agreement, a dedicated product team was formed (see Exhibit 4 for an organizational chart). The team had several immediate challenges. On the medical side, phase II human trials needed to be completed, and phase III human trials had to be carefully designed and carried out. These trials would give the team a better understanding of the medical effects of the drug on ED patients and more clearly define its safety profile. On the marketing side, though completion of these clinical phases was not expected anytime soon, there was a sense of urgency with respect to the need for conducting market research. Given Lilly’s resources, it would lead this endeavor. ICOS, though fully taking part in all key decisions, would gradually ramp up its marketing presence on the team, using Lilly as a “scaffolding’’ upon which to build its own marketing competence.

Marketing Competence at Lilly

In the mid to late 1990s, Lilly had essentially rethought the way marketing should be integrated into product development and introduction. Several reasons contributed to this shift. First, many of the big pharmaceutical companies were embracing a high-risk high-return strategy, with product development efforts concentrated on finding the next big blockbuster drugs. Lilly was particularly focusing on the discovery and development of innovative drugs (i.e., “first-”or “best-in-class” vs. “me-too” alternatives). Also, CEO Taurel specifically instructed his Lilly employees not to bother with any drug unlikely to top $500 million in annual sales.12 Second, alongside spending on finding cures for chronic and life-threatening medical conditions (such as cancer, cardiovascular diseases, and high cholesterol), industry resources were increasingly being allocated to the development of “quality-of-life” medicines. Such drugs treat chronic conditions that are not life threatening or severely debilitating (such as male baldness, male erectile dysfunction, female sex disorder, or skin rejuvenation) and are hence typically not covered by most health plans. For these drugs, marketing’s role in identifying attractive market segments and convincing both doctors and patients to embrace them was of great importance and could build on Lilly’s strategy of innovation. Third, the FDA revised the rules on prescription drug promotion in 1997. This facilitated direct-to-consumer (DTC) advertising and particularly affected the ability of pharmaceutical companies to use TV media to influence the demand for their offerings beyond the traditional detailing of doctors.13 After only four years the results were quite dramatic. Studies showed that nearly a third of all adults initiated discussion with their doctors about drugs they saw advertised on TV, with 44% of those adults then receiving a prescription.14

10 http://alliances.lilly.com/ (Lilly website). 11 Profits in all other regions were to be retained by Lilly, after a royalty was paid to the joint venture. 12 “Eli Lilly: Life After Prozac,” BusinessWeek, July 23, 2001. 13 Detailing sessions are visits to doctors’ offices by sales reps to give physicians information about the appropriate use, efficacy, dosage, side effects, contraindications, and studies regarding new and existing prescription drugs. 14 “Pushing Prescription Drugs,” CBS News Healthwatch, November 30, 2001.

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GMSO

As a result of the above trends, Lilly management made a conscious effort to get marketing much more involved in the product development cycle, while taking care not to run afoul of the company’s ethical and regulatory obligations. To facilitate this process, a separate body within the firm, called the Global Marketing Sales Organization (GMSO), was set up. GMSO had three subfunctions— Global Marketing Planning (GMP), Global Market Research (GMR), and Global Marketing Sales Training (GMST). In the initial stage of new-product planning, when Lilly scientists would experiment with several chemical compounds that could potentially have medical benefits, GMSO had two roles. First, it would funnel ideas for research projects based on the ongoing input from sales reps visiting physicians and market needs identified by GMR. Second, for projects that seemed to have medical effectiveness in phase I and II clinical trials, GMP would forecast market potential to see whether these projects should be terminated or moved forward. Projects that looked promising would then be assigned a fully dedicated cross-functional product team, with medical, marketing, registration, and logistics functions. In this stage, phase III clinical trials would be completed, with the end goal of registering the drug with the FDA. Given that the results of trials would ultimately impact the medical claims that could be made about a particular drug, the product team’s marketing function would be involved in the initial planning of these trials. But more importantly, its role was to translate the medical implications of the drug into future commercial success. In these more advanced stages of product development, GMSO personnel would act as consultants to the product team by providing marketing research resources and assistance in putting together five-year forecasts. GMSO would also conduct brainstorming sessions for the product team, called “deep dives.” Mark Kershisnik, executive director of GMP, elaborated:

The pharmaceutical industry is in many ways about the marketing of negatives. By taking a drug, a person is reminded she or he has a problem, that something is wrong with them. It is important when thinking about how to take a drug to market to be cognizant of possible scenarios that involve physician, patient, public, or competitor reactions. Through the ongoing experience gained in the GMSO, we can help the product team effectively prepare for these scenarios and in many cases preempt them.

Affiliates

To effectively manage all promotional, sales, and after-sales activities worldwide, Lilly organized its efforts geographically by creating distinct affiliates with regional responsibilities. For Cialis, primary affiliates included the United States, five major countries in Europe, Canada, Australia, Mexico, and Brazil. Affiliates would get involved with a new drug through a series of “brand councils” held at Lilly headquarters in Indianapolis. The purpose of these meetings was to let the product team present its vision for the positioning and branding of the new drug and lay out key drivers of success. GMSO would prepare sales forecasts and provide a common reporting format for post-launch tracking. The brand councils allowed the affiliates to get a clear picture of how to maximize profits in their respective region and ensured all parties involved were aligned.

At any given time, affiliates would handle numerous Lilly drugs at various stages in the life cycle. Affiliates had dedicated resources and personnel and received budgets to reflect the level of activities for all the products (or brands) under their control. The affiliates enjoyed a certain degree of flexibility to manage their budgets across the portfolio of drugs. Chad McBride and Ryan Ranck, senior members of GMP assigned to Cialis, explained: “An affiliate could not simply decide to not carry an assigned product and was generally committed to the success of all products. However, the exact amount of spending, the allocation of salespeople, the choice of sponsorship events [e.g., local symposia and conferences], and management time were discretionary across products. This meant

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that if a product team was able to do a more convincing job in the brand councils, their brand was likely to get a higher priority with the affiliates.”

In the case of Cialis, the joint venture’s management would have tighter control of the total budget allocated to the territories in which profits would be shared between Lilly and ICOS. In addition, given that the U.S. market was recognized as being particularly important, the U.S. affiliate brand team, headed by Matt Beebe, was made an integral part of the product team’s marketing function.

Understanding the ED Market

It was evident to the product team that a prerequisite for a successful launch was solid up-front market research, even if such a launch was three or four years down the road. One of the first challenges the product team faced was coming up with a name for the new drug. Brown, the global marketing director, advocated a neutral name that did not convey any strong connotations, so that a brand meaning could later be molded into the product once the team understood the market better. After testing numerous alternatives, checking for potential negative associations in many languages and ensuring no trademark conflicts, the name “Cialis” was chosen.15

Physicians

It seemed natural to begin with a preliminary understanding of how physicians viewed ED treatment. In early 1999, a preliminary conjoint study was performed with 350 doctors, with a roughly even split between urologists and primary-care physicians (PCPs).16 Across both sets of doctors, the study revealed that efficacy (the fraction of patients for whom the drug would be effective) was the most important attribute, followed by safety. These two attributes accounted for a relative importance of roughly 70%. The duration attribute (indicating how long one dosage of the drug can improve ability to achieve an erection) was noted by the respondents to have a relative importance of less than 10%.17

To get a better sense of attitudes toward the treatment of ED, a set of interviews was conducted with physicians at several medical conferences. The interviews revealed that knowledge about ED varied between urologists and PCPs. As expected, urologists were quite familiar with the medical causes and incidence of ED and were comfortable talking about it with patients. PCPs, however, were a different story. The interviews revealed that the majority of PCPs would not feel comfortable discussing sexual problems with their patients during yearly checkups. This was true even if the individual suffered from one of the diseases associated with ED (see Exhibit 1) and hence was at higher risk of incurring erectile disorders. Many expressed apprehensions about prescribing a drug like Viagra to patients who had entrusted them with their health, citing the recent deaths associated with the use of Viagra. The inability to perform sexually was secondary in their opinion to the potential risks arising from the drug. Of those that did prescribe medication for ED, close to 90% said

15 Interestingly, most pharmaceuticals use the generic drug name prior to FDA approval (for example, Viagra was publicly referred to as sildenafil citrate prior to FDA approval). But “Cialis” would be used by Lilly and ICOS to refer to their product throughout the later stages of the clinical trials and approval process (and not referred to by its generic name of tadalafil). 16 Primary-care physicians care for the general health needs of their patients. They coordinate referrals to specialists and arrange for applicable testing and hospitalization when necessary. Primary-care physicians are trained in internal medicine (diagnosis and treatment of the adult population), pediatric medicine (diagnosis and treatment of children and adolescents), or family practice medicine (diagnosis and treatment of both adults and children). 17 Results from the conjoint study were transformed so that the importance of each attribute was given as a percentage. The other attributes in the study related to onset time and side effects.

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the patient had initiated the request for the drug. These doctors also confessed they would typically not proactively follow up on the drug’s success.

Patients

Though Cialis would definitely be a prescription drug, Brown pushed for a better understanding of the ED patient perspective. As a result, in June of 1999 GMR undertook a six-month study to explore how consumers in the United States and Europe (France, Germany, Italy, Spain, and the United Kingdom) viewed ED and its treatment. To do so, a screening survey was administered to 32,644 patients visiting their PCPs (across all countries). Of the original sample, 28,022 replied they did not suffer from ED, 2,450 reported suffering ED but had not sought treatment, while the remaining 2,172 sought treatment for their condition. The screening phase revealed some interesting statistics on ED prevalence by age and country and other demographic information (see Exhibits 5 and 6). As expected, the prevalence of ED increases with age. In all countries the average ED patient was in his 50s, with over 80% having a sexual partner. The U.S. ED patients seemed to be more highly educated than in other countries.

To gain a deeper understanding of the drivers of consumer behavior, a follow-up questionnaire was then administered to those screened to have ED. The first set of questions aimed to establish how individuals who perceived they had ED progressed through the six stages (or nodes) of dealing with their condition, through what Lilly marketers termed the “Health Care Transaction Model” (HCTM) (see Figure A). Each node in the model represents the fraction of patients from the node above to have continued to the current stage of the model.

Figure A Health Care Transaction Model

Perception Consultation Treatment Delivery Compliance Evaluation

Source: Lilly ICOS.

The results revealed that fewer than half of those who perceived they had ED consulted a physician and that the type of physician consulted varied by country (Exhibit 7a). A variety of factors were found to influence ED patients to seek treatment (Exhibit 7b), with spouse or sex partner the most highly cited. Probing on the barriers to seeking treatment revealed that different reasons figured prominently depending on age (see Exhibit 8). In particular, younger men expressed higher levels of embarrassment in talking about the condition and were waiting for it to go away, while for older men the belief that this was a normal phenomenon of aging seemed to create a reluctance to seek treatment. According to the study, for those who did seek treatment, Viagra was the most commonly suggested medication. Most patients filled the first prescription they received (see Exhibit 9 for information on the location and payment for the prescription).

The level of satisfaction with Viagra, among all those who had tried it, was measured. The results, presented in the table below, revealed that a substantial percentage of males were not entirely satisfied with Viagra.

Perceive they have condition

Consult their doctor about condition

Receive a prescription

Fill the prescription

Actually take the medication

Intend to refill prescription

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Table A Satisfaction with Viagra

Satisfaction Level U.S. (%) France (%) Germany (%) Italy (%) Spain (%) U.K. (%) Very satisfied 24 23 27 28 29 23 Somewhat satisfied 34 49 57 51 37 36 A little satisfied 19 20 14 16 14 11 Not at all satisfied 23 8 3 5 19 30

Source: Lilly ICOS.

Future intent to use Viagra was broken down into three groups based on past usage behavior: Viagra current users, Viagra dropouts (used Viagra at least once in the past but discontinued usage), and those who had never used Viagra. In the United States, 91% of current Viagra users expressed high/very high intent to continue taking the drug in the future, 46% of Viagra dropouts reported high/very high intent to use the drug in the future, and only 39% of those who never tried Viagra reported intent to ask for it in the future. The trend was similar in other countries.

The second set of issues in the survey explored more directly how the end patient would value Cialis. Respondents first gave their relative importance for four different attributes associated with an ED drug. The results were broken down by Viagra usage (see Exhibit 10). In addition, subjects were asked for their interest in trying Cialis in the future (based on the drug’s written profile). The relatively high willingness to try Cialis across countries (see Table B) was encouraging.

Table B Interest in Trying Cialis (%)a

U.S. France Germany Italy Spain U.K.

Viagra current users 90% 97% 97% 58% 70% 100% Viagra dropouts 84 68 89 52 70 100

Source: Lilly ICOS.

aPercentages represent respondents who agreed or strongly agreed with the statement: “I am willing to try this new drug.” Written profile described Cialis as having a 30-minute onset time, allowing a 24-hour window of opportunity, and that it could not be taken with nitrate.

The extensive survey was also complemented by more qualitative input. Mark Blakely, who was managing GMR’s involvement with Cialis, helped the product team conduct a series of 45-minute in-depth interviews with ED patients. Even though half of those interviewed were current Viagra users and half non-Viagra users (with a mix of Viagra dropouts and those who never tried the drug), Blakely was struck by the common “downward spiral” dynamic characterizing the ED condition: