A study of 5 million insured adults, conducted between 1998 and 2002, found that the number of men under age 45 using Viagra more than tripled. "These findings suggest increased use of Viagra as an enhancement or recreational agent," said the prescription-drug tracking firm Express Scrips in the study, published in the August 2004 issue of the International Journal of Impotence Research.

Viagra sales topped $1.9 billion in 2003.

"Already concerned with the impact Viagra has had on their pharmacy budgets, health-plan sponsors now face the prospect of increased use among a younger, healthier generation of patients," said study leader Tom Delate. "In addition, marketing approval of other erectile dysfunction drugs, such as Levitra and Cialis, will likely increase utilization of such drugs."

Delate, T., Simmons, V., & Motheral, B. (2004) Patterns of use of sildenafil among commercially insured adults in the United States: 1998-2002. International Journal of Impotence Research, 16(4): 305-312

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