The following is a summary of “Downstream Revenue Realized by Facilities Placing Inflatable Penile Prosthesis in Medicare Beneficiaries to Treat Erectile Dysfunction,” published in the April 2024 issue of Urology by Sun et al.
This retrospective claims analysis aimed to meticulously quantify the incremental downstream revenue generated from subsequent treatment trajectories of men undergoing inflatable penile prosthesis (IPP) implantation for erectile dysfunction (ED), contrasting their revenue impact with a meticulously matched cohort of men devoid of ED.
Utilizing the 100% Medicare Standard Analytic Files, researchers meticulously examined 5-year revenue dynamics, delineating the economic outcomes among patients receiving IPP for ED vis-à-vis a propensity-matched cohort sans ED. The study cohort consisted of men aged 65 years or older who had undergone IPP implantation (as per Current Procedural Terminology® 54405) in a hospital outpatient setting between January 1, 2016, and December 31, 2021.
Crucially, these individuals maintained continuous Medicare Parts A and B enrollment for 12 months preceding the index IPP procedure and continued for five years post-index IPP discharge date. For comparability, the study group identified and meticulously selected a comparator group of men without ED exhibiting comparable characteristics. The revenue accrued by hospitals from Medicare constituted the sum of payments for patient services, other payor-paid amounts, patient deductibles, copayments, and coinsurance, all inflated to 2022 US dollars. The investigators report mean values alongside their corresponding standard deviations (SD) to offer a comprehensive understanding.
Following meticulous matching, the cohort comprised 2,905 men with ED who underwent IPP implantation and 7,462 men without ED. Intriguingly, the IPP cohort exhibited a markedly elevated 5-year cumulative revenue (mean=$34,571 [SD=$50,234]), in stark contrast to their counterparts without ED (mean=$3,189 [SD=$11,527]). Stratification by diagnosis revealed notable discrepancies in revenue, with differences amounting to $10,258 for circulatory disease, $2,646 for diabetes, $2,013 for urological conditions, and $1,043 for prostate cancer. Impressively, a significantly higher proportion of IPP patients encountered health services for these conditions over the 5-year follow-up than their matched controls, underscoring the comprehensive healthcare utilization dynamics
In conclusion, the study underscores that men with ED who opt for IPP not only incur substantially higher healthcare revenue over 5 years, nearly tenfold compared to those without ED but also exhibit augmented healthcare utilization across a spectrum of medical conditions. These findings accentuate the profound financial implications for enhancing access to essential care for individuals grappling with advanced ED, empowering healthcare facilities to allocate resources judiciously to deliver indispensable healthcare interventions to this patient demographic.
Source: sciencedirect.com/science/article/pii/S0090429524002905