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Implantable Penile Prosthesis for Erectile Dysfunction: Insurance Coverage in the United States.

Mohit Khera1, Joshua P Langston2, Matthew E Pollard3

  • 1Baylor College of Medicine, Houston, Texas.

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Approximately 80% of patients have implantable penile prosthesis coverage, but employer exclusion is a growing barrier. This trend highlights disparities in health insurance for erectile dysfunction treatment.

Keywords:
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Area of Science:

  • Urology
  • Health Services Research
  • Medical Devices

Background:

  • Erectile dysfunction (ED) affects a significant portion of the male population, necessitating various treatment options.
  • Implantable penile prostheses are a crucial treatment for severe ED, but access is often dictated by health insurance coverage.
  • Understanding insurance coverage patterns is vital for patient access to ED treatments.

Purpose of the Study:

  • To evaluate United States health plan insurance coverage for implantable penile prostheses for erectile dysfunction.
  • To analyze trends in coverage approval and identify reasons for denial, particularly employer exclusions.

Main Methods:

  • Analysis of a manufacturer's benefit verification database, including all-payer and employer-sponsored health plans.
  • Data from 2018-2021 were queried to determine implantable penile prosthesis approval status.
  • Assessment of coverage variations by payer type and over time, with a focus on reasons for lack of coverage.

Main Results:

  • Overall implantable penile prosthesis coverage was approximately 80% across all analyzed health plans.
  • Government-based insurance (Medicare, Medicare Advantage, Tricare, VA) demonstrated higher coverage rates (80-100%) compared to commercial insurance (75%).
  • Employer exclusion was the primary reason for denied coverage, increasing by 29.3% from 2019 to 2021.

Conclusions:

  • Despite high overall coverage, employer exclusions represent a significant and increasing barrier to implantable penile prosthesis access.
  • Coverage is more favorable through government-sponsored health plans than commercial options.
  • Addressing employer exclusions is critical to improving equitable access to ED treatment via penile prostheses.