Login to Access Video or Poster Abstract: MP25-04
Sources of Funding: None

Introduction

Erectile dysfunction is reported in up to 50% of men 40 years old and older, with the real number likely higher due to negative reporting bias. Although first line medication options have increased in the last few decades, approximately 30-35% of men still fail oral medications. Furthermore, healthy men are reporting average sexually active life expectancies up to 70 years old. We analyzed the cost-effectiveness of intracorporeal injection (ICI) therapy versus inflatable penile prostheses (IPP) management for patients who fail Viagra therapy.

Methods

We performed a cost effective analysis using published complication and efficacy data, Medicare reimbursement costs, and commercial cost data. We compared the cost of IPP treatment including rate of infection, mechanical failure and re-operation with ICI treatment over a 15-year time-span, which is the average life of an IPP.

Results

Compared with ICI, IPP was more cost-effective although the overall cost (ICI $15,570 vs IPP $13,571) and health utility (ICI 0.93 vs IPP 0.92) was comparable in both groups. One-way sensitivity analysis showed that injections became cheaper, while maintaining similar efficacy at a cost less than $17.22 per injection. Similarly, when the frequency of monthly sexual intercourse fell below 3.5 times per month, ICI became the less costly option.

Conclusions

The average sexual lifespan of a healthy man in his 50s is estimated at 15 years and increasing. The price of injections and the rate of monthly injections were significant factors driving costs. Our study shows that IPP is the less costly approach for men overall. However, for men who successfully respond to less costly injection formulations and are happy with a lower frequency of monthly sexual intercourse, ICI may be a less costly option with similar successful outcomes.

Funding

None