
A good friend is at that stage in life where he needs Viagra or Cialis to function properly. He has found that off-brand Viagra from India is 1/7 the cost of the brand name stuff from the local pharmacy, but works just as well. As a result, his sex life is truly festive far more often than if he depended on the expensive stuff. From India, it's cheap enough to use whenever the urge strikes; bought locally, it isn't.
The situation is much like that troubling the entertainment industries: their products are so overpriced that no one sheds a tear when they are pirated.
Footnotes:
1. While there's a lot of fake, non-functional Viagra (and Cialis) on the web, there are also good versions that work as advertised.
2. The Indian courts have held that Pfizer's patent on Viagra is not valid in India, thus pharmaceutical companies there are free to make it, though trademark laws prevent them calling it "Viagra".