Cost Consideration for the Treatment of Peyronie's Disease: A Narrative Review

Peyronie's disease (PD) is an acquired penile deformity that causes penile shortening, narrowing, erectile dysfunction, and pain. Current treatment modalities include penile traction therapy (PTT), Collagenase Clostridium histolyticum (CCh) injections, and surgical straightening procedures which have varying levels of expected deformity correction and associated side effects. Similarly, these treatments have varying levels of both out-of-pocket and total costs for the healthcare system as a whole. This review aims to summarize the current literature regarding the costs of treatment modalities available for PD.

Current well-supported treatment options for PD can be categorized into three groups: PTT, CCh, and surgical straightening. CCh injection therapy is gaining popularity but remains the single most expensive therapy for PD. PTT has demonstrated modest curve reduction efficacy, and may be an approachable initial therapy modality for select patients. Penile plication and penile plaque incision/excision surgery are more definitive surgical options that are less expensive than CCh injections but more expensive than PTT. While the literature continues to evolve with emerging guidelines and FDA approvals, PTT remains the lowest absolute cost option while CCh injections and penile plication surgery are the higher cost options. PTT and injection therapy are time intensive which must be taken into account in any discussion of cost-effectiveness. More research remains to be performed to consider cost-effectiveness of various treatment options for PD patients while taking into account efficacy, opportunity cost, and patient quality of life. Urologists treating patients with PD must understand the economic aspects of the evolving treatment landscape to effectively guide management for each patient to enhance quality of life and patient outcomes.