(400) Geographic Disparity in Collagenase Clostridium Histolyticum Utilization: A National Population-Based Analysis

Abstract

Abstract Introduction In 2013, the Food and Drug Administration approved the use of intralesional collagenase clostridium histolyticum for the treatment of Peyronie’s Disease. Objective To describe geographic utilization patterns of collagenase clostridium histolyticum. Methods The Medicare Provider Utilization and Payment Database was queried for all collagenase clostridium histolyticum injections (Current Procedural Terminology code 54200) performed between 2013 and 2020. The United States Census Bureau estimates for state population by male sex for 2020 were used to calculate the number of injections per male capita. Linear regression was performed with statistical significance set to 95% confidence intervals. Results Twenty-two states accounted for a total of 8,576 injections performed on 1,887 men. Five states (Georgia, California, Florida, North Carolina, and Delaware) represented over 50% of the injections per million male capita (figure). There were 28 states with zero injections recorded in the database. The number of injections per year increased from 263 in 2013 to 1,388 in 2020 (y=141.43x + 435.57, R2=0.71, p=0.008). All 8,576 injections were performed in urban vs. rural areas. Urologists and advanced practice providers (APPs) performed 8,309 (97%) and 267 (3%) of these procedures, respectively. The average reimbursement was $80.19 (SD $3.87) for urologists and $67.96 (SD $3.33) for APPs. Conclusions In this national population-based database, there was geographic disparity in the use of collagenase clostridium histolyticum for Peyronie’s Disease. Utilization increased fivefold from 2013 to 2020 and was limited to urban centers and less than half the states. APP’s performed a minority of injections. Disclosure No.