Abstract
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. We 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.
References
- 1 : Impotence. JAMA1993; 270: 83. Google Scholar
- 2 Publication PHS 87-1751. Washington, D. C.: United States Department of Health and Human Services 1987. Google Scholar
- 3 : Socioeconomic considerations in erectile dysfunction treatment. Urol Clin North Am2001; 28: 417. Google Scholar
- 4 : Health-related quality of life in men with erectile dysfunction. J Gen Intern Med1998; 13: 159. Google Scholar
- 5 : The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology1997; 49: 822. Google Scholar
- 6 :
Definitions, classification, and epidemiology of sexual dysfunction . In: . Edited by . Paris: Health Publications Ltd2004: 37. Google Scholar - 7 : Drug therapy: erectile dysfunction. New Engl J Med2000; 342: 1802. Google Scholar
- 8 : Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol2001; 166: 569. Link, Google Scholar
- 9 : Sexual function of men ages 40 to 79 years: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. J Am Geriatr Soc1995; 43: 1107. Google Scholar
- 10 : Epidemiology of erectile dysfunction: a community-based study in rural New York State. Ann Epidemiol2000; 10: 293. Google Scholar
- 11 : Predictors and prevalence of erectile dysfunction in a racially diverse population. Arch Int Med2006; 166: 207. Google Scholar
- 12 : Help-seeking decisions among men with impotence. Urology1998; 52: 834. Google Scholar
- 13 : Patterns of use of sildenafil among commercially insured adults in the United States: 1998–2002. Int J Impot Res2004; 16: 313. Google Scholar
- 14 Pfizer Annual Report. : 2005. Available at http://www.pfizer.com/pfizer/annualreport/2005/annual/review2005.pdf. Accessed August 15, 2005.. Google Scholar
- 15 Eli Lilly Annual Report. : 2005. Available at http://investor.lilly.com/annuals.cfm. Accessed August 15, 2005. Google Scholar
- 16 Bayer Annual Report. : 2005. Available at http://www.bayer.com/annualreport_2005. Accessed August 15, 2005. Google Scholar
Department of Urology, University of Washington School of Medicine, Seattle, Washington, RAND Corp., Santa Monica, California, and Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota

