Forget popping Viagra or Cialis in plain old pill form. In 2024, erectile dysfunction patients have an abundance of candy-like choices from direct-to-consumer health companies. There’s wintergreen tablets courtesy of Hims and blue chewable tablets from Bluechew. At Ro, which launched under-the-tongue tablets Ro Sparks earlier this year, the company is taking a cue from a big trend in vitamins for its newest erectile dysfunction product: the first prescription gummy.
Ro’s Daily Rise gummies contain 7 mg of tadalafil—the main ingredient in Cialis—in a beaming yellow, tropical fruit-flavored form.
“We’re trying to unlock spontaneity for our patients,” says Zach Reitano, cofounder and CEO of Ro, who suffers from erectile dysfunction himself—a side effect from heart medication. He points out that since the gummies can be taken daily, patients don’t have to worry about planning when to take their medication so they can have sex.
He also gives credit to the reason gummies have come to dominate everything from the vitamin and supplements space—they actually taste good, which can increase adherence. Plus, he sees the bright packaging as helping remove the stigma of taking a pill. To get access to the Daily Rise Gummy, customers can schedule a telehealth appointment with one of Ro’s doctors in as little as one day and then receive a prescription for the Daily Rise Gummy (or any of Ro’s other products, depending on the patient’s need). Ro also allows for unlimited messaging with a provider in case patients have any follow up questions.
An estimated 30.3 million men or 18% of men in the U.S. have erectile dysfunction, however only about 9 million have sought treatment and gotten diagnosed. The prevalence of erectile dysfunction is rising particularly for younger men. However, there are still barriers to treatment such as difficulty of access (it can take up to a month to get an appointment), as well as shame.
This makes online providers which promise an immediate appointment online instead of in person meeting, particularly attractive. It also means there’s profit to be made: The erectile dysfunction market was valued at about $2.5 billion in 2022, and estimated to grow about 9%. The Daily Rise Gummy costs $2 a day, while generic Viagra and Cialis is about 30 cents a pill through programs such as GoodRx. For Ro, the gummy offers a way to entice new ED customers as the company branches out into more costly offerings, including weight-loss drugs like Ozempic and Wegovy.
Dr. Peter Tsambarlis, a urologist and assistant professor at Northwestern’s Feinberg School of Medicine, is skeptical about the therapeutic value these new formulations add. He points out that many of these compounds use the same ingredients as Viagra and Cialis, except they are more expensive. “The main innovation of these DTC pharmacies seems to be a different delivery method to achieve a rapid onset similar to chewing the pill without the [accompanying] battery acid taste and a more robust marketing campaign,” he says.
More pressingly, he worries about patients who skip out on the benefits of a thorough examination from a urologist or primary care provider. “I know my wait lists are long—it’s the largest complaint I get, but often times erectile dysfunction can be a signal something else is wrong—such as heart disease,” he says. “Direct-to-consumer pharmacies can be a great resource, but if something isn’t going right, if dosing isn’t working and you want to manipulate your therapeutic plan, having someone who already knows you is a huge asset,” he says.
For Reitano, the new products are ultimately about reducing barriers to treatment for ED. “If you look at how erectile dysfunction is discussed, there’s a lot of stigma,” he says. “We’re trying to switch from negative to positive and talk about goal-oriented healthcare and having better and more spontaneous sex. You can do a lot to help people when you remove stigma.”