Brink Sarah M, Iarajuli Teona, Shin David
Department of Urology, Hackensack University Medical Center, 360 Essex Street, Suite 403, Hackensack, NJ 07601, United States.
Department of Urology, Hackensack Meridian School of Medicine, 123 Metro Boulevard, Suite 4100, Nutley, NJ 07110, United States.
Sex Med. 2023 Aug 2;11(4):qfad038. doi: 10.1093/sexmed/qfad038. eCollection 2023 Aug.
Due to the sensitivity and potential embarrassment of discussing erectile dysfunction (ED) in person, men are seeking treatment online.
We sought to compare offerings of direct-to-consumer (DTC) platforms for ED treatment with respect to consultation, pricing, services, and privacy policy.
Google was queried to identify DTC platforms offering ED treatment with the keywords: "telehealth erectile dysfunction," "telemedicine erectile dysfunction," and "online erectile dysfunction." Inclusion criteria were as follows: serving a majority of U.S. states, existing online only, providing both the consultation and prescription for phosphodiesterase type 5 inhibitors, and delivering the prescription to the patient.
Fifteen DTC platforms met criteria. Ten provided free consultations; 4 bundled the consultation fee with the first month of the prescription, with 1 of these functioning as a subscription service. Fourteen (93%) relied on online intake forms and 10 (67%) advertised review by the prescriber within 2 business days. Only 4 (27%) platforms explicitly advertised physician-only consults. Direct contact with the prescriber would only occur if needed or if required by state law at 8 (53%) platforms. Purchasing sildenafil and tadalafil was advertised on all platforms. Minimum prices of sildenafil ranged from $0.50 to $35/pill (mean $5.16/pill, median $2.65/pill); tadalafil ranged from $0.50 to $9.80/pill (mean $4.70/pill, median $3.21/pill). In addition to ED therapy, 13 (86%) platforms offered treatment for other men's health issues. All platforms included a website privacy policy, but only 10 (67%) mentioned Health Insurance Portability and Accountability Act compliance, with 2 of these claiming to not be covered entities.
Although DTC platforms are transparent with phosphodiesterase type 5 inhibitor medication and subscription pricing information, few offer direct contact with a physician to further discuss issues related to ED after completion of the online intake form. For comprehensive evaluation of ED in Health Insurance Portability and Accountability Act-compliant settings, in-person or telemedicine visits should be arranged with men's physicians.
由于当面讨论勃起功能障碍（ED）具有敏感性和潜在的尴尬性，男性正在寻求在线治疗。
我们试图比较直接面向消费者（DTC）的勃起功能障碍治疗平台在咨询、定价、服务和隐私政策方面的情况。
通过在谷歌上搜索关键词“远程医疗勃起功能障碍”“远程医学勃起功能障碍”和“在线勃起功能障碍”来识别提供勃起功能障碍治疗的DTC平台。纳入标准如下：服务美国大部分州，仅在线运营，提供5型磷酸二酯酶抑制剂的咨询和处方，并将处方递送给患者。
15个DTC平台符合标准。10个提供免费咨询；4个将咨询费与第一个月的处方捆绑在一起，其中1个作为订阅服务。14个（93%）依赖在线 intake 表格，10个（67%）宣传开具处方的医生会在2个工作日内进行评估。只有4个（27%）平台明确宣传仅由医生进行咨询。在8个（53%）平台上，只有在需要或州法律要求时才会与开具处方的医生直接联系。所有平台都宣传了西地那非和他达拉非的购买情况。西地那非的最低价格从每片0.50美元到35美元不等（平均每片5.16美元，中位数每片2.65美元）；他达拉非的价格从每片0.50美元到9.80美元不等（平均每片4.70美元，中位数每片3.21美元）。除了勃起功能障碍治疗外，13个（86%）平台还提供其他男性健康问题的治疗。所有平台都有网站隐私政策，但只有10个（67%）提到符合《健康保险流通与责任法案》，其中2个声称不属于受该法案涵盖的实体。
尽管DTC平台在5型磷酸二酯酶抑制剂药物和订阅定价信息方面是透明的，但在完成在线 intake 表格后，很少有平台提供与医生直接联系以进一步讨论与勃起功能障碍相关问题的机会。对于在符合《健康保险流通与责任法案》的环境中对勃起功能障碍进行全面评估，应安排男性患者与男科医生进行面对面或远程医疗就诊。
