Johns Hopkins University School of Medicine, Baltimore, MD.
Boston Scientific, Marlborough, MA.
Urology. 2021 Mar;149:140-145. doi: 10.1016/j.urology.2020.11.051. Epub 2020 Dec 10.
To 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.
A 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.
Between 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).
ED 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.
调查参加雇主赞助健康保险（ESHI）计划的男性中每年勃起功能障碍（ED）的患病率，并评估有 ED 诊断的患者的 ED 治疗情况。
使用 IBM MarketScan 商业数据库进行了一项横断面理赔分析，该数据库是美国参加 ESHI 计划的工人的全国代表性样本。纳入了 2009 年至 2017 年期间至少有一次 ED 医疗诊断索赔且在给定年份连续参保的年龄在 18-64 岁的患者。在有 ED 诊断的患者中，确定了以下 ED 治疗方法的使用率：磷酸二酯酶 5 抑制剂（PDE5I）、阴茎假体植入术、其他 ED 治疗方法（如真空勃起装置、尿道栓剂）、联合治疗以及没有保险公司支付的治疗方法。
2009 年至 2017 年间，参加 ESHI 的男性 ED 患病率每年增加 116%。然而，2017 年仅有 23%的 ED 诊断患者接受了 ESHI 计划支付的 ED 治疗。服用 PDE5I 的男性比例从 2012 年的 18%到 2015 年的 26%不等。近年来，接受阴茎假体植入术的 ED 男性比例有所下降（2009 年为 0.23%，2017 年为 0.11%）。同样，2009 年至 2017 年期间，接受其他 ED 治疗或联合治疗的男性比例也有所下降（分别为 0.94%-0.30%和 0.65%-0.19%）。
参加 ESHI 计划的男性 ED 患病率显著增加，但约四分之三的男性没有 ED 治疗索赔，表明在治疗方面存在巨大的获得途径差距。
