(358) Improved Healthcare Utilization Among Men with Depression Undergoing Inflatable Penile Prosthesis in a United States Commercial Population

Abstract

Abstract Introduction Inflatable penile prosthesis (IPP) is widely considered medically necessary and a definitive treatment to restore erectile function, yet employer benefit exclusion and lack of insurer coverage of IPP implantation among non-Medicare men may limit their access to the treatment that can negatively impact quality of life. While previous research examined the impact of penile implants among men with depressive symptoms, limited evidence is available to quantify the impact of IPP on depression-related healthcare utilization including emergency department, inpatient, outpatient, and office visits among this patient population. Objective To evaluate the real-world healthcare utilization associated with depression among men undergoing IPP in a US commercial population. Methods A retrospective claims-based analysis was conducted using the 85% Merative™ MarketScan® commercial database to identify men aged ≥18 undergoing IPP (CPT 54405) between 2007 and 2020. Male patients were included if they had at least one claim of depression as a primary diagnosis one-year pre-index IPP and did not have any IPP during this period. Patients were required to have one-year continuous enrollment pre- and post-index IPP. Healthcare utilization associated with a primary diagnosis of depression including number of emergency department visits, inpatient visits, outpatient visits, office visits, and total healthcare visits were measured one-year pre- and post-index IPP. The total healthcare visits included all sites of service for depression. A paired t-test was conducted to evaluate the differences pre- and post-index IPP among patients using the Instant Health Data software (Panalgo, Boston MA, USA) and R, version 3.2.1 (R Foundation for Statistical Computing, Vienna, Austria). Results Among 11,177 patients identified with an IPP during the index period, 808 patients had depression. Average age was 55.26 (±6.83) and average Charlson comorbidity score was 1.63 (±1.67). A statistically significant reduction in the mean number of total healthcare visits, inpatient visits, and office visits were observed pre- and post-index IPP. The mean number of total healthcare visits in the pre-IPP period was 4.88 ± 7.71 compared to 3.82 ± 8.48 in the post-index IPP period (P<0.0001). Among these, the mean number of inpatient visits in the pre-index IPP period was 0.07 ±0.57 compared to 0.03 ±0.22 in the post-index IPP period (P=0.02) and the mean number of office visits in the pre-index IPP period was 4.25 ±7.17 compared to 3.29 ±7.84 in the post-index IPP period (P<0.0001). Conclusions The study provides evidence highlighting the benefits of IPP in alleviating the healthcare resource utilization associated with depression among men undergoing an IPP. For these benefits to be fully realized, it is critical to ensure comprehensive coverage of medically necessary IPP among commercially insured patients with depression. Disclosure Yes, this is sponsored by industry/sponsor: Boston Scientific. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.