Published in: The Journal of Urology, v. 177, no. 5, May 2007, p. 1675-1681
Posted on RAND.org on January 01, 2007
PURPOSE: Male sexual health has taken on increased importance as the United States population ages, develops coexisting medical conditions and undergoes interventions that can affect sexual function. The authors characterized the burden and severity of disease, treatment patterns and economic consequences of erectile dysfunction. MATERIALS AND METHODS: The analytical methods used to generate these results were described previously. RESULTS: Erectile dysfunction was self-reported by almost 1 of 5 men and it increased with age. Erectile dysfunction may have been more commonly reported in Hispanic men and in those with a history of diabetes, obesity, smoking and hypertension. In most databases black American men had rates of use for office visits and inpatient hospital care that were twice those of other racial groups, although these rates were not controlled for comorbid conditions or other regional and socioeconomic factors. The use of diagnostic tests markedly decreased, while pharmacological therapy, especially with oral phosphodiesterase-5 inhibitors, markedly increased. Penile implant surgery continued to be performed with most patients electing inflatable devices. Extrapolating from the population based estimates of erectile dysfunction prevalence and current use trends showed that the cost of treatment nationwide could reach $15 billion if all men sought treatment. CONCLUSIONS: The burden of disease due to erectile dysfunction in the United States will increase with the aging of the male population, increasing prevalence of comorbid conditions, expanded treatment seeking behavior and costs of pharmaceutical therapy. Accurate estimates of economic cost will require better understanding of pathogenesis, treatment seeking behavior, patient preference for therapies, success of treatments and relative satisfaction with oral pharmacotherapy and penile implants.