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Erectile dysfunction in spinal cord injury: a cost-utility analysis
Nicole Mittmann1, B Catherine Craven, Michael Gordon
1Department of Pharmacology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, 2075 Bayview Avenue E240, Toronto, Ontario M4N 3M5, Canada. nicole.mittmann@sw.ca
Journal of Rehabilitation Medicine
|November 17, 2005
Summary
Sildenafil is a cost-effective oral treatment for erectile dysfunction in individuals with spinal cord injury. It offers a better health preference and economic value compared to non-oral treatments.
Area of Science:
- Urology
- Rehabilitation Medicine
- Health Economics
Background:
- Erectile dysfunction (ED) is common after spinal cord injury (SCI), significantly impacting quality of life.
- Available ED treatments include oral sildenafil, intracavernous injections (Caverject, Triple Mix), MUSE, prosthetic devices, and vacuum erection devices.
- Physical limitations in SCI patients can hinder the use of non-oral ED therapies.
Purpose of the Study:
- To evaluate the cost-effectiveness of oral versus non-oral ED treatments in the SCI population.
- To compare the economic value and patient health preferences for various ED therapies from a government payer perspective.
Main Methods:
- A cost-utility analysis was performed on a cohort of 59 SCI patients.
- Patient health preferences were assessed using the standard gamble technique.
- Economic modeling compared sildenafil against other oral and non-oral ED treatments.
Main Results:
- Sildenafil demonstrated a dominant economic strategy compared to prosthetic devices, MUSE, and Caverject.
- The incremental cost-utility ratios for sildenafil versus Triple Mix and vacuum devices were favorable, below CAN$20,000 per quality-adjusted life year gained.
- Patients expressed a higher health preference for oral therapy.
Conclusions:
- Sildenafil is a cost-effective treatment option for erectile dysfunction in the SCI population.
- Oral sildenafil provides superior economic value and patient preference over non-oral ED treatments for SCI patients.