Quantifying the number of US men with erectile dysfunction who are potential candidates for penile prosthesis implantation

INTRODUCTION: Penile prosthesis implantation (PPI) is a treatment option recommended in clinical guidelines for erectile dysfunction (ED). However, a limited number of urologists perform PPI procedures in the United States. AIM: To quantify the number of insured men with ED in the United States and project the number of potential candidates for PPI in 2022. METHODS: An Excel-based disease impact model was constructed using a top-down estimation approach. The starting US male population consisted of adult men from 2022 US Census data after exclusion of age-specific mortality rates from the National Vital Statistics Reports. Men with health insurance were included in the model based on insurance status data from the US Census database. ED prevalence and ED treatment rates were obtained from administrative claims data analyses—the Merative MarketScan Commercial Database (18-64 years) and the 5% Medicare Standard Analytical Files (≥65 years)—and literature-based estimates of patient-reported ED prevalence. OUTCOMES: The number of men with ED in the United States and the number of potential candidates for PPI were estimated. RESULTS: By utilizing ED prevalence based on administrative claims, an estimated 8.3% of insured men (10,302,540 estimated men [8,882,548 aged 18-64 years and 1,419,992 aged ≥65 years]) had a diagnosis of ED and sought ED care, out of 124,318,519 eligible US men aged ≥18 years in 2022. An estimated 17.1% of men with an ED diagnosis claim could benefit from PPI in 2022 (1,759,248 men aged ≥18 years). Patient self-reported ED prevalence across all ages ranged from 5.1% to 70.2%. Scenario analyses applying the patient self-reported ED prevalence range revealed the number of men in the United States who could benefit from PPI could have been higher than 1.7 million if their ED symptoms were diagnosed by health care providers. CLINICAL IMPLICATIONS: Most men with ED in the United States are undertreated, and many could benefit from PPI. STRENGTHS AND LIMITATIONS: This analysis is a US population–level estimation. However, given this study utilized a variety of assumptions, the results may vary if different model assumptions are applied. CONCLUSIONS: This disease impact model estimated that approximately 10.3 million men were diagnosed with ED by their health care providers and sought ED care in the United States in 2022. Of those, 1.7 million men could be PPI candidates and benefit from the treatment option.