The average per-patient cost for treating Peyronie’s disease increased 5-fold between 2007 and 2018, a new Sexual Medicine study reports.
Approval of collagenase injections by the U.S. Food and Drug Administration (FDA) in late 2013 could account for much of the increase, the authors said.
Thought to affect up to 3% of men, Peyronie’s disease causes hardened areas called plaques to form beneath the skin of the penis. Because of the plaques, the penis curves, sometimes to the point that intercourse becomes difficult. Men are usually treated with oral medications, a course of injection therapy, or surgery, depending on the severity of their situation.
To learn more about incidence and costs related to Peyronie’s disease treatment, the researchers consulted a database of patients covered by over 350 health insurance plans in the United States. They identified 88,642 men who were diagnosed with Peyronie’s disease from 2007 to 2018.
During that period, the incidence of new Peyronie’s disease cases rose from 61 patients per 100,000 in 2007 to 77 patients per 100,000 in 2018. The researchers weren’t sure why the numbers increased, but it’s possible that doctors and patients became more aware of Peyronie’s disease over that time. It’s also possible that patients saw more advertising for Peyronie’s disease treatments. There might have been a simple increase in cases as well.
Also during the time period, the annual percentage of men who received any type of treatment for Peyronie’s disease rose from 17.8% in 2007 to 26.2% in 2018.
Which treatments were the most common? Rates of oral medication use rose from 5.5% in 2007 to 10.8% in 2018. The percentage of men who had surgery decreased from 4.7% in 2007 to 3.1% in 2018.
Percentages of men having injection therapy stayed between 7% and 9% from 2007 to 2013. After that, figures started reflecting the FDA approval of injectable collagenase. By 2018, about 14% of the Peyronie’s disease patients were having injection therapy.
Next, the researchers examined treatment costs. Overall, the average amount spent per patient in 2007 was $1,531. By 2018, the figure jumped to $10,339. However, costs depended on the type of treatment. Oral medications were the least expensive per individual, ranging from $42 in 2007 to $175 in 2018. (Oral drugs were calculated per patient on an annual basis.)
Surgery costs per patient (including fees for the procedure itself but not hospital, anesthesia, or related fees) averaged $4,255 in 2007 and $10,930 in 2018. (Surgery costs were calculated for each procedure.)
Annual injection costs per patient rose from $811 in 2007 to $16,184 in 2018. As part of this analysis, the researchers also considered costs of collagenase injections after FDA approval. In 2014, these injections cost an average of $17,187. In 2018, the figure was $20,260. (Injection therapy costs were calculated for each course of injections received by a patient.)
The increase in costs is likely explained by the “widespread use of injectable collagenase,” and not healthcare inflation, the authors said. However, it is still unclear whether collagenase injections are cost-effective over the long term.
“It will be critical for future studies to assess long-term outcomes so that practitioners may fully counsel patients on both the financial and therapeutic effects of injectable collagenase,” the authors wrote.
The findings might not be applicable to all patient populations, they added.
Loftus, Christopher J., MD, et al.
“Treatment Trends and Cost Associated With Peyronie's Disease”
(Full-text. Article in press. Published: October 6, 2020)