PIH15 - The Economic Burden of Erectile Dysfunction and Related Comorbidities: A Medicare Perspective

Abstract

The objectives of this study were to assess the prevalence of diagnosed erectile dysfunction (ED) in a Medicare population and examine the economic burden associated with management of ED patients and related comorbidities. We conducted a retrospective observational cohort study using a 5% sample of the Medicare Standard Analytic Files from 2009 to 2015. A constant weight of 20 was applied to obtain national estimates of the prevalence of ED. To estimate the economic burden, we identified male patients with an ED diagnosis in 2010 and matched 1:5 ED patients with non-ED controls based on demographic characteristics and comorbidity profiles. We examined all-cause healthcare costs and disease specific costs, defined as total costs of encounters with a primary diagnosis of ED. The prevalence of ED in the Medicare population increased significantly from 1.08 million patients in 2009 to 1.47 million patients in 2015.We identified 59,584 men with ED diagnoses in 2010; after matching 25,317 remained in the ED cohort. Before matching, the most common comorbidities among ED patients were hypertension (67.9%), dyslipidemia (67.7%), and diabetes (30.6%). 89% of patients had at least one comorbidity of interest. Total Medicare expenditures following diagnosis were 33% and 20% higher in patients with ED during year 1 ($8,465 vs $6,369, P<.05) and year 5 ($ 40,871 vs $ 34,019, P<.05) respectively, than in the matched non-ED controls. The ED-specific cost accounted for less than 1% of total Medicare expenditures. Outpatient healthcare services accounted for 70% of the cost differences. The prevalence of ED has increased in recent years. Patients with ED incurred significantly higher Medicare expenditures than those without ED. However, the ED-specific cost was only a small proportion of total Medicare expenditures. ED patients, if treated properly, may have improved quality of life and better disease management of associated comorbidities.