106 Cost Effectiveness of Peyronie’s Disease Therapies: A Comparison of RestoreX Penile Traction Therapy, Collagenase Clostridium Histolyticum, and Surgery

Abstract

A novel penile traction therapy (PTT) device, RestoreX, has recently been suggested as a potential minimally-invasive therapy for the management of Peyronie’s disease (PD). Given the current medical environment of value-based care and cost containment, we sought to compare PTT with RestoreX to other standard PD therapies to evaluate for efficacy, adverse events, and cost-effectiveness. To directly compare RestoreX PTT (RxPTT) against collagenase clostridium histolyticum (CCH) and surgery (penile plication or incision and grafting [I&G]) using a cost-effectiveness model among men with PD. A decision analytic model was created to compare the cost-effectiveness of treatment with RxPTT versus CCH versus penile plication or I&G. Cost-effective models account for actual costs, costs of complications, and impact of complications on overall quality of life (QALY). Outcomes were derived from prospective or randomized databases of 78 patients treated with regular use of a novel traction device, 192 patients undergoing CCH, and 23 patients treated with plication or I&G. Data included baseline patient and disease characteristics, complications, and outcomes for each modality. Costs were derived from our hospital financial department and utility values from the literature. For the base-case primary analysis, success was defined as ≥20% improvement in curvature. Two secondary analyses were performed with success defined as restoration of penetration and a final absolute curvature ≤20°. We reported incremental costs and incremental effectiveness for each treatment option, and performed a sensitivity analysis by varying each input value across a set range.