背景和研究目的 Massachusetts Male Aging Study 的研究指出40到70歲的男性當中約52%有勃起功能障礙，由此推估台灣陽萎患者約有200萬人；而這些患者當中估計只有10%曾經使用過威而鋼，因此治療勃起功能障礙藥物在台灣的潛在市場相當可觀。理論上這是醫師處方用藥，實際上有八成的藥物是從藥局未經醫師處方賣出，其銷售模式等同於非必需品的銷售模式。2003年第四季樂威壯和犀利士在台灣上市後，原來由威而鋼獨占的市場變成三家藥廠寡占，競爭也趨白熱化。本研究目的在:1) 分析三家藥廠的行銷策略，2) 探討影響醫師處方習慣的因素，3) 探討影響消費者購買意向的因素，4) 分析藥局藥師對這三種藥物的支持度。
研究方法 首先和各家產品經理進行深度訪談了解其行銷策略，同時要他們評估各種影響藥品選擇因素在醫師和消費者心目中的重要性，以及利用學術研討會影響醫師處方習慣的可能性。再以問卷調查探討影響醫師處方習慣的因素：如藥物特性、安全性、價格、和同儕意見等，特別著重藥廠的行銷策略是否真能改變醫師的處方決定。對於消費者本研究則探討影響患者自行選購藥物的因素，特別著重患者對於所謂藥品好壞的看法和醫師以及藥廠行銷人員有無落差。最後再以當面訪談方式分析藥局藥師是否特別偏好推銷何種藥品。本研究還以交叉分析方式探討藥廠產品經理、醫師和患者在看法上有何差異。
結果 輝瑞的策略是持續對醫師強調威而鋼的安全性和藥效，同時藉民眾衛教開發潛在市場。拜耳則以開發未曾浮出檯面的患者為首要目標，設法使治療陽痿藥物回復到處方用藥的正途，同時努力使樂威壯成為醫師眼中最佳的治療用藥。禮來把幾乎所有的行銷資源都集中在藥房通路，完全以商品而非藥品的方式來銷售犀利士。醫師處方藥物時最在意是否有效和副作用；85%的醫師首選藥物是威而鋼，21%的醫師對犀利士的安全性存有疑慮，多數醫師把樂威壯視為威而鋼的二線替代用藥。各家藥廠明顯高估意見領袖、文獻和研討會對醫師處方習慣的影響。患者最在意的是有沒有效，再來是安不安全；這一點有利於威而鋼。和醫師相比，患者更重視藥物開始發生作用、和藥效持續的時間。20%的消費者基於好奇心或不實際的期望而購買，62%的購買行為是偶發的，1/3的威而鋼使用者有過嘗試其他新藥的念頭。藥師並不會特別喜歡推薦哪一種藥物。
結論 由於人口老化加上男性勃起功能障礙的被廣泛討論，治療陽痿藥物的市場在可見的未來將持續大幅成長。新進入者雖然可以引爆一波銷售佳績，但真正勝負還是得靠藥物的基本面包括藥效和安全性。在醫師和患者眼中，藥物安全都是一個非常重要的考量因素；因此威而鋼仍將繼續佔有領先地位，甚至還有繼續成長的機會。犀利士以其特長藥效仍將擁有一批忠實的愛用者，這些人通常不是真正的患者，也常擁有多重性伴侶。樂威壯和威而鋼幾乎沒有差異性，拜耳“經由意見領袖影響醫師處方行為”的行銷策略從本研究結果來看大概很難奏效。加上不當的上市策略，樂威壯打敗其他兩種藥品的機會應該是微乎其微。

Background and Purpose: The Massachusetts Male Aging Study found 52% of men aged 40 to 70 years suffered from erectile dysfunction (ED). Approximately two millions men in Taiwan were ED suffers, only 10% of them had taken Viagra®. The potential market is very attractive to pharmatheutical industry. By law, ED medicines are prescriptive drugs; in practice, more than 80% of ED drugs were sold without prescription in Taiwan. The launch of Levitra® and Cialis® has boosted the competition in the ED drug market. The purposes of this study are 1) to compare the marketing strategies of Viagra®, Levitra® and Cialis®, 2) to analyze factors influencing physicians’ prescription, 3) to analyze factors affecting drug purchasers’ decision, and 4) to survey the preference of drugstores owners on selling these drugs.
Materials and Methods: The first step is face-to-face, in-depth interviews with product mangers to understand their marketing strategies. We will ask them to rate the significance of factors (e.g. efficacy, safety, price) affecting physicians’ and patients’ preference. Product mangers will be requested to rate the importance and relevance of the way product messages delivered to doctors’ prescription behaviors. Questionnaires will be mailed to all urologists in Taiwan to survey factors they concerned when prescribing. We use mailing questionnaires and face-to-face interviews to assess the impact of drug efficacy, duration, safety, etc. on drug purchasers’ decision. Drugstores owners will be interviewed to understand their favor in promoting certain drug. Comparative studies will be done to evaluate the difference between product mangers, physicians and patients.
Results The marketing strategy of Pfizer is to emphasize the well-documented efficacy and long-term safety of Viagra® by seminars for physicians. Educational talks will be given to the public to explore the potential consumers. The goal of Bayer is to urge the silent ED suffers search for medical help, and to convince physicians that Levitra® is the drug of choice for ED patients. Eli-Lilly put almost all their marketing efforts and resources in drugstores. Drug efficacy and safety are most important factors influencing physicians’ prescription. Approximately 85% of urologists surveyed favor Viagra®, 21% have safety concern on Cialis®. Most urologists considered Levitra® as alternative of Viagra® when failed. All product mangers overestimate the impact of key opinion leaders, literature, and seminars on physicians’ prescription behaviors. Patients’ survey disclosed that drug efficacy and safety are most important factors affecting drug purchasing. As compared to physicians, patients have more concern on the time of onset and duration. About 20% of drug purchasers are not ED suffers; 62% of purchasing is sporadic, one third of Viagra® users have the attempt to try other ED drugs. The drugstores owners have no specific preference for any drugs.
Conclusions The extension of life expectancy and open discussion of male ED problem had resulted in tremendous growth of ED drug market. The launch of new drug may stimulate the selling amount in short run; the long-term market shares depend mainly on the drug efficacy and safety. In our study, we found that safety profile is the main concern for both physicians and drug purchasers. We believed that Viagra® may stay as the market leader, while Levitra® may have only small market share. Certain groups of drug purchasers, especially fake ED suffers and those who with multiple sex-partners will have high brand loyalty to Cialias®.

第壹章 緒論………………………………………………………….. 1
第一節 研究背景與動機……………………………………………………… 1
第二節 研究目的……………………………………………………………… 2
第貳章 文獻探討……………………………………………………... 4
第一節 三種藥物藥理特性比較……………………………………………… 4
﹝一﹞Phosphodiesterase type 5 (PDE5) inhibitor作用機轉………………... 4
﹝二﹞Sildenafil (Viagra®，威而鋼)………………………………………… 4
﹝三﹞Vardenafil (Levitra®，樂威壯)………………………………….……. 4
﹝四﹞Tadalafil (Cialis®，犀利士)………………………………………….. 5
第二節 新產品成敗的原因…………………………………………………… 7
﹝一﹞新產品成功的因素…………………………………………………… 7
﹝二﹞新產品失敗的行銷原因……………………………………………… 8
第三節 整合性行銷溝通……………………………………………………… 9
第四節 藥品行銷策略………………………………………………………… 9
第五節 非必需品行銷策略…………………………………………..………... 11
第叁章 研究架構與研究方法………………………………………. 13
第一節 研究架構………………………………………………………………. 13
第二節 研究方法與可能困難…………………………………………………. 14
﹝一﹞產品經理訪談…………………………………………………………. 14
﹝二﹞泌尿科醫師的問卷調查………………………………………………. 15
﹝三﹞患者的問卷調查………………………………………………………. 16
﹝四﹞藥師的訪談……………………………………………………………. 17
第三節 研究流程………………………………………………………………. 17
第肆章 結果與分析…………………………………………………. 18
第一節 產品經理訪談總結……………………………………………………. 18
﹝一﹞威而鋼的競爭策略……………………………………………………. 18
﹝二﹞樂威壯的競爭策略……………………………………………………. 19
﹝三﹞犀利士的競爭策略……………………………………………………. 20
第二節 泌尿科醫師問卷調查結果……………………………………………. 21
第三節 醫院購藥患者問卷調查結果…………………………………………. 23
第四節 藥房自行購藥患者訪談結果…………………………………………. 24
第五節 藥劑師的訪談結果……………………………………………………. 25
第六節 三種藥品SWOT分析………………………………………………… 26
﹝一﹞威而鋼的SWOT分析………………………………………………… 26
﹝二﹞樂威壯的SWOT分析………………………………………………… 26
﹝三﹞犀利士的SWOT分析………………………………………………… 27
第七節 三種藥品行銷策略分析比較…………………………………………. 28
﹝一﹞對威而鋼行銷策略的評析………………………………………….… 29
﹝二﹞對樂威壯行銷策略的評析……………………………………………. 29
﹝三﹞對犀利士行銷策略的評析……………………………………………. 30
第伍章 結論…………………………………………………………. 32
參考文獻………………………………………………………………………….… 40
附錄一：三家藥廠產品經理的訪談問卷……………………………………….… 44
附錄二：泌尿科專科醫師的問卷……………………………………………….… 47
附錄三：使用者的問卷………………………………………………………….… 50

圖 表 目 錄

表一：目前國內三種核可上市之陽痿藥物比較表……………………………….. 6圖一：影響醫師和患者品牌選擇的決策過程……………………………………. 13
圖二：醫師和患者對威而鋼整體滿意度…………………………………………. 34
表二：醫師心目中的首選藥物﹝患者VS.自己或親友﹞……………………….. 35
表三：醫師用藥偏好和執業地點、醫療院所類型、年齡和專科醫師年資的關係 …..……………………………………………………………………... 36
表四：醫師、患者和藥廠產品經理心目中影響選擇藥物因素的重要性﹝平均數﹞ ………………………………………………………………………. 37
表五：醫師和藥廠產品經理心目中各種藥品資訊傳遞方式的可信度以及因而改變醫師處方習慣的可能性…………..………………………………………. 38
表六：醫師、患者和藥廠產品經理心目中影響選擇藥物因素的重要性﹝中位數﹞ ………………………………………………………………………. 39

中文部份
1. 日祥醫事管理顧問公司，2001，台灣地區男性性功能障礙現況調查研究報告。
2. 黃俊英，2003，行銷學的世界 第二版 台北：天下文化。
3. 蔣曉秋，2002，影響醫師處方藥品的重購意願之探討，碩士論文，義守大學管理研究所。

西文部份
1. Anderson EW, Sullivan MW. (1993) : The antecedents and consequence of
customer satisfaction for firms. Marketing Science 12:125-143 2. Araujo AB, Johannes CB, Feldman HA, Derby CA, McKinlay JB. (2000): Relation between psychosocial risk factors and incident erectile dysfunction: prospective results from the Massachusetts Male Aging Study. American Journal of Epidemiology. 152:533-541
3. Brock G., Nehra A, Lipshultz LI, Karlin GS, Gleave M, Seger M, Padma-Nathan H. (2003): Safety and efficacy of vardenafil for the treatment of men with erectile dysfunction after radical retropubic prostatectomy. Journal of Urology. 170 (4 Pt 1):1278-12834. Brock GB, McMahon CG, Chen KK, Costigan T, Shen W, Watkins V, Anglin G, Whitaker S.(2002): Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. Journal of Urology. 168 (4 Pt 1): 1332-1336
5. Churchill GA, Jr., Surprenant C.(1982): An investigation into the determinants of customer satisfication. Journal of Marketing Research 19:491-504
6. Fink HA, MacDonald R, Rutks IR, Nelson DB, Wilt TJ. (2002): Sildenafil for male erectile dysfunction: a systematic review and meta-analysis. Archives of Internal Medicine. 162(12):1349-1360
7. Gresser U, Gleiter CH.(2002): Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil--review of the literature. European Journal of Medical Research. 7:435-446
8. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. (1998) : Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine 338:1397-1404
9. Goldstein I, Young JM, Fischer J, Bangerter K, Segerson T, Taylor T.(2003): Vardenafil Diabetes Study Group. Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care. 26:777-783
10. Gonzalgo ML, Brotzman M, Trock BJ, Geringer AM, Burnett AL, Jarow JP. (2003) : Clinical efficacy of sildenafil citrate and predictors of long-term response. Journal of Urology 170(2 Pt 1):503-506
11. Gwinner KP, Gremler DD, Bitner MJ.(1998): Relational benefits in service industries: The customers perspective. Journal of the Academy of Marketing Science 26:101-114
12. Hellstrom WJ, Gittelman M, Karlin G., Segerson T, Thibonnier M, Taylor T, Padma-Nathan H. (2002): Vardenafil for treatment of men with erectile dysfunction: efficacy and safety in a randomized, double-blind, placebo- controlled trial. Journal of Andrology. 23:763-771
13. Hellstrom WJ, Gittelman M, Karlin G, Segerson T, Thibonnier M, Taylor T, Padma-Nathan H. (2003): Vardenafil Study Group. Sustained efficacy and tolerability of vardenafil, a highly potent selective phosphodiesterase type 5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial. Urology. 61(4 Suppl 1):8-14
14. Kevin R, Berkowitz E, Hartley S, Rudelius W. (2003): Marketing, 7th ed. Boston: McGraw-Hill, Irwin, pp 274-277.
15. MaMahon CG, Samali R, Johnson H.: Efficacy. (2000):Safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction. Journal of Urology, 164:1192-1196
16. Mayer M, Beatty SE, Coleman JE, Reynolds KE, Lee J. (1996): Customer-sales associate retail relationships. Journal of Retailing, 72: 223-247
17. McKinlay, JB. (2000): The worldwide prevalence and epidemiology of erectile dysfunction. International Journal of Impotence Research, 12: S6
18. NIH Consensus Development Panel on Impotence.(1993) NIH consensus conference: impotence. Journal of American Medical Association, 270:83–90.
19. Reynolds KE, Beatty SE.(1999): Customer benefits and company consequence of customer- salesperson relationships in retailing. Journal of Retailing, 75:11-32
20. Robert Cooper, (1996): “New product: What separates the winners from the losers”, in M. Rosenau, Jr.,et al, eds. The PDMA handbook of New Product Development, New York: Wiley
21. Saenz de Tejada I., Anglin G, Knight JR, Emmick JT.(2002): Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care 25:2159-2164
22. Schartizer D, Kollarits HC.(2000): Satisfied customers: profitable customer relationships: pharmaceutical marketing: How pharmaceutical representatives can achieve economic success through relationship management with general-practitioners- an empirical study. Total Quality Management, 11:955-965
23. Stief CG, Uckert S, Becker AJ, Truss MC, Jonas U.(1998): The effect of the specific phosphodiesterase inhibitors on human and rabbit carvernous tissue in vitro and in vivo. Journal of Urology 159:1390-1393.