Presentation Authors: Arthur Burnett*, Baltimore, MD, Sirikan Rojanasarot, Stacey Amorosi, Marlborough, MA
Introduction: Most commercial insurers' published medical policies provide coverage for erectile dysfunction (ED) treatments. However, a considerable number of employer-sponsored health (ESH) plans exclude ED treatment benefits, creating access gaps to ED treatments and inequality between men insured by different plan types. ED treatments range from prescription medications, such as phosphodiesterase-5 inhibitors (PDE5I), to penile prosthesis (PP) devices. The objectives of this study were to evaluate the annual prevalence of ED in a working age population and explore treatment profiles of men with ESH insurance.
Methods: We conducted a cross-sectional claims analysis utilizing Truven Health MarketScan Commercial data from 2009 to 2016. The data includes claims for a nationally representative sample of US workers enrolled in an ESH plan. We identified men aged 18-64 with at least one ED claim and continuous enrollment in a given year. Patient demographics and clinical characteristics were explored. Utilization rates of ED therapies among those with an ED diagnosis were evaluated and categorized as: PP, PDE5I, other ED treatments (eg, vacuum pump, intracavernosal alprostadil), combination treatment, and no insurer-paid treatment. Utilization rates reflect paid claims only.
Results: Between 2009 to 2016, the annual prevalence of ED reported among men insured by an ESH plan increased by 82% (Figure 1). Their mean age was 50 years, with a standard deviation of 9 to 10 years. A majority of men with an ED diagnosis had no treatments on their claims (between 73% and 81%). Overall, less than 30% of men with ED received an ED therapy paid by their ESH plans. The proportion of men taking PDE5I has remained relatively stable, fluctuating between 18% and 26%. The rate of men with ED who underwent PP implantation has declined in recent years (0.23% to 0.11%). The rate of men who received other ED treatments or combination treatment has also decreased (0.94% to 0.31% and 0.65% to 0.24%, respectively).
Conclusions: ED reported among men insured by an ESH plan has increased dramatically, yet roughly three-quarters of these men had no claim for ED treatments. The decrease in the rate of men undergoing PP implantation and other ED treatments may reflect access gaps to effective ED treatments. Steps should be taken to ensure men with ED have equitable access to ED therapies.
Source of Funding: Boston Scientific Corp