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CVD screening in men with erectile dysfunction cost-effective
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Screening for CVD risk factors in men who present with erectile dysfunction could be a cost-effective intervention for the prevention of CVD and erectile dysfunction in the long term, according to a new analysis.
Researchers examined the cost of screening men with erectile dysfunction for CVD risk factors, and the cost savings of treating risk factors.
“Based on our model, we call for a paradigm shift that moves research and treatment of [erectile dysfunction] away from merely deriving symptomatic improvement in the disease to a proactive and comprehensive view that appreciates and attempts to reverse the underlying and concurrent vascular pathology,” Alexander W. Pastuszak, MD, PhD, from the Center for Reproductive Medicine and the Scott Department of Urology at Baylor College of Medicine, Houston, and colleagues wrote.
The researchers calculated the known incidence and prevalence of erectile dysfunction and CVD, the rate of undiagnosed CVD and the effects of CVD treatment to model the change in prevalence of acute CVD events and erectile dysfunction as a function of the number of men with erectile dysfunction and CVD. They then estimated cost savings associated with reducing acute CV events and the prevalence of erectile dysfunction over 20 years.
Nearly 2 million have both conditions
The incidence of CVD in the United States is 4.83 cases per 1,000 men per year, the incidence of erectile dysfunction in patients with CVD is 47.1 cases per 1,000 men per year and the prevalence of CVD in the United States is 81.1 per 1,000 men. Based on previous research showing that the RR for CVD in men with erectile dysfunction is 1.47, the number of U.S. men with CVD is approximately 8.8 million and the number of U.S. men with erectile dysfunction is approximately 18 million, the researchers estimated that 1,991,520 U.S. men have both CVD and erectile dysfunction.
Given that about 44% of U.S. men with CVD risk factors are unaware of their risk, the researchers estimated that if all men presenting with erectile dysfunction were screened for CVD, there would be 5.8 million men identified over 20 years with CVD risk factors that were previously unknown.
Savings outweigh costs
This screening would cost $2.7 billion, according to the researchers. If screening and treatment resulted in a 20% decrease in CV events, 1.1 million CV events would be avoided and $21.3 billion would be saved over 20 years, they wrote. Likewise, 1.1 million cases of erectile dysfunction would be treated, saving $9.7 billion. The reduction in treatment cost for CVD and erectile dysfunction would save $28.5 billion over 20 years, according to the results.
The number needed to screen to avoid one acute CVD event is 12.04, the researchers wrote.
“These findings further substantiate the recommendation of the Princeton Consensus Conference encouraging [CV] risk stratification in men with erectile dysfunction,” Pastuszak said in a press release. “We can now highlight the benefits of this screening approach and its impact on the health care system.” – by Erik Swain
Disclosure: Pastuszak reports no relevant financial disclosures.
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