RCV, thanks for the URL. I decided to copy a portion of it here for the thread since the numbers were quite interesting:
>>Erectile Dysfunction in Diabetes
Aaron Vinik, MD,PhD, FCT, FACP, and Donald Richardson, MD
ÿErectile dysfunction (ED) is the consistent inability to attain and maintain an erection adequate for sexual intercourse. The term impotence implies failure of the individual and should be abandoned in favor of terms such as penile failure or penile unreliability, or even ED, thus placing the responsibility with the offending organ and not the person.
An estimated 10-15 million men in the United States (more than 10%) have ED. One in every three men will experience the problem. The prevalence of ED in men with diabetes has been estimated to be between 35 and 75%.1,2
Figure 1 shows the major causes of ED in the United States. Diabetes accounts for 30%, and vascular disease, of which diabetes is the dominant contributor, for 40%. Surgery to the prostate and urogenital area, spinal cord injuries, and multiple sclerosis combined account for about 24%, and endocrine disorders for only about 3-6%.
After the age of 70 years, two-thirds of the general male population have ED. The incidence of ED in men with diabetes between the ages of 20-29 years is 9%, but it rises to 95% by age 70 years. In fact, it may be the presenting symptom of diabetes. Indeed, the later the onset of diabetes, the earlier the onset of ED. It may herald the development of diabetes and even precede abnormalities in glucose tolerance. More than 50% of men with diabetes notice the onset of ED within 10 years of the onset of diabetes.
Nevertheless, a large segment of the public and many health professionals remain uninformed or misinformed about ED. This lack of information, added to the reluctance of physicians to deal candidly with their patients' sexual problems, has resulted in patients being denied treatment despite a variety of therapeutic options.
Before discussing treatment options, however, let us consider the reasons for concern for patients with ED. Erectile dysfunction is a marker for the development of generalized vascular disease and premature demise from myocardial infarction. It has been said that the penis is a divining rod capable of identifying individuals at risk for a vascular catastrophe long before it occurs. As a corollary, the prevalence of diabetes in men with ED is 50%, compared with 7% in an age-matched non-diabetic population. ED is associated with elevated total and low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, and reduced levels of dehydroepiandrosterone sulfate (DHEA-S), known risk factors for coronary vascular disease.ÿ
IN BRIEF
Erectile dysfunction occurs in 50-75% of men with diabetes. The etiology is multifactorial and the diagnosis of the cause(s) can be made by a logical stepwise algorithm. Treatment is oriented towards removing the cause or using new pharmacotherapies.<<
There are a few points I would like to raise here in regard to the estimates that have been made and argued about in regard to ED. It seems that we have pretty widely varying estimates of ED, even from the experts, so it is my feeling that we should refrain from jumping on each other over various estimate disagreements. It would be more useful to try and dig up more information and make better arguments regarding the estimates.
The above article estimates 10-15M men suffering from ED in the US. From what I have seen so far, I think it is fair to assume the 50% figure is, on the average, correct for predicting the number of diabetics suffering from ED. It may be that the 20M total figure we have seen from VVUS is the high side of the estimates and that a more accurate estimate may be 14-15M.
Of course, it is the nasty nature of this problem that many will not seek treatment (as many as 50% or more) for it because of the associated embarrasment. My guess is that this will change over the next ten years as many baby boomers (like myself) begin to experience ED, since it is MOST CLEARLY an age related problem (after age 70, 2/3 of the general male population experience ED).
The baby boomer generation reared on books by Dr. Spock and familiar with sensitivity training is used to getting its way and will not let a little embarrassment stop it.. Men will be living longer and healthier lives and wanting to engage in their natural birthright as long as they can. And their wives and girlfriends will also be living longer and seeking sexual fulfillment. So the numbers of men seeking treatment for ED will continue to grow.
As TA points out, the American market is just a small part of the worldwide market, so the room for market expansion is, for the purposes of VVUS, virtually unlimited. This is a key point. Whether the estimates are 10 or 20M, it really doesn't matter.
The main problem with the MUSE treatment as I see it is, let's face it, no one wants to stick something up their Johnson if they don't have to. Thus I believe that most of the recent price decline (besides the fact that many high fliers have been hard hit in the recent market correction) is due to the likely competition from Viagra. This introduces a lot of uncertainty into the VVUS market. If VVUS finds a way to deliver this orally, they will rocket out of sight.
That being said, VVUS should continue to grow well with their present treatment. Those who have used the treatment and found it successful are likely to show a high degree of loyalty (think about it), although they may be slow to tell their friends. They will tell their doctors who will tell their friends. As several on the thread have argued, new treatments such as Viagra will call more attention to the problem and bring more men into their doctors offices for treatment. The silence will start to lift from this disease as it has from breast cancer and prostate cancer.
Let's take a mid-range figure of 15M for ED here in the US and double it when we include Europe. 30M sufferers (60M if we include their wives). Can anyone doubt that the market for VVUS and MUSE will rapidly expand? And continue to grow strongly for years to come. Say VVUS eventually captures only 10% of this market. 3M users. What sort of market cap might that give the stock? |
