Abstract
ObjectiveTo investigate the annual erectile dysfunction (ED) prevalence among men enrolled in an employer-sponsored health insurance (ESHI) plan and evaluate ED treatment profiles among those with an ED diagnosis. MethodsA cross-sectional claims analysis was conducted using the IBM MarketScan Commercial Database, a nationally representative sample of US workers enrolled in ESHI plans. Patients aged 18-64 with at least one ED medical diagnosis claim and continuous enrollment in a given year between 2009 and 2017 were included. Among those with an ED diagnosis, utilization rates of the following ED treatments were determined: phosphodiesterase type 5 inhibitors (PDE5I), penile prosthesis implantation, other ED treatments (eg, vacuum pump, intraurethral suppositories), combination treatment, and no insurer-paid treatments. ResultsBetween 2009 and 2017, the annual prevalence of men with ESHI suffering from ED increased by 116%. However, in 2017, only 23% of men with an ED diagnosis received an ED therapy paid for by their ESHI plans. The proportion of men taking PDE5Is ranged from 18% in 2012 to 26% in 2015. The proportion of men with ED undergoing penile prosthesis implantation has declined in recent years (0.23% in 2009 to 0.11% in 2017). Similarly, the rate of men who received other ED treatments or combination treatment has decreased from 2009 to 2017 (0.94%-0.30% and 0.65%-0.19%, respectively). ConclusionED prevalence among men insured by an ESHI plan has notably increased, yet approximately three-quarters of these men had no claims for ED treatments, indicating substantial access gaps to treatment.
Highlights
Despite employer-sponsored health insurance (ESHI) being the largest source of health insurance, a considerable number of ESHI plans exclude erectile dysfunction (ED) treatment benefits.[5]
The annual ED prevalence and ED treatment profiles among men with an ED diagnosis from 2009 to 2017. This real-world analysis found that the annual prevalence of ED among men ages 18-64 insured by an ESHI plan increased by 116% from 2009 to 2017, yet only 22% of these men received an ED therapy paid for by their ESHI plans
Many working men with ED are covered by ESHI plans that exclude ED treatments, which may explain the low utilization rates of ED treatments among the working-age, employed population. This present study provides a long-term trend of ED prevalence and comprehensive treatment profiles of US men enrolled in ESHI plans
Summary
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.[1]. In 2018, more than half of all Americans who had health insurance received health benefits from employers.[4] Despite ESHI being the largest source of health insurance, a considerable number of ESHI plans exclude ED treatment benefits.[5] When a person is insured by an ESHI plan, the employer determines what benefits are excluded or covered—not the insurance company These exclusions create inequalities between working men with ESHI plans and men covered by Medicare or Marketplace health insurance plans.[6,7]. Men with ED often experience depression, loss of self-esteem, increased anxiety, limited intimacy, increased anger, and relationship issues.[8] ED poses a significant burden on employee productivity.[8] An observational study in adult men aged 40-70 showed that compared to men without ED, men with ED had significantly higher rates of absenteeism (7.1% vs 3.2%) and work productivity impairment (24.8% vs 11.2%).[8] providing appropriate ED treatments through ESHI plans may improve men’s overall health and work productivity. Statistical analyses were undertaken with R, version 3.2.1 (R Foundation for Statistical Commuting, Vienna, Austria)
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