Most Patients Have Implantable Penile Prosthesis Coverage
Medically reviewed by Drugs.com.
By Elana Gotkine HealthDay Reporter
THURSDAY, Aug. 24, 2023 -- Most patients have coverage for implantable penile prosthesis for erectile dysfunction, with employer exclusion the most common reason for lacking coverage, according to a study published online in the Sept. 1 issue of Urology Practice.
Mohit Khera, M.D., M.P.H., from Baylor College of Medicine in Houston, and colleagues queried all-payer and employer-sponsored health plan benefit verification databases to determine implantable penile prosthesis approval status. Data were presented for 2019 to 2021 for the all-payer analysis (3,167 patients in 2019; 3,016 in 2020; and 2,837 in 2021) and from 2018 to 2021 for the employer-sponsored health plan analysis.
The researchers found that most patients from the all-payer analysis were approved or verified for implantable penile prosthesis coverage (79.4, 79.6, and 78.4 percent in 2019, 2020, and 2021, respectively). For government-based insurance, coverage was most extensive (98.7, 97.1, 100, and 80 percent for Medicare, Medicare Advantage, Tricare, and Veterans Affairs, respectively), but favorable coverage was also seen for commercial insurance (75.0 percent). Employer exclusion was the most common reason for lack of coverage. From 2019 to 2021, there was an increase in the proportion of patients with no coverage due to exclusion from 13.5 to 17.5 percent. Overall, 63.1 percent of the 3,083 patients in the employer-sponsored health plan database were approved or verified for coverage; 34.2 percent did not have coverage due to exclusions in the health plan.
"Our study raises concerns that some insurance plan policies are denying an effective, research-proven therapy, for a very common condition for which treatment is considered medically necessary," Khera said in a statement.
Several authors disclosed ties to the pharmaceutical and medical device industries, including Boston Scientific, where several authors are employed.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
© 2024 HealthDay. All rights reserved.
Posted August 2023
Read this next
Voluntary Medical Male Circumcision May Reduce Risk for HIV Infection
TUESDAY, May 28, 2024 -- For men who have sex with men (MSM), voluntary medical male circumcision (VMMC) is associated with a reduced risk for HIV infection, according to a study...
New Tool IDs Sexual Struggles in Female Partners of Prostate Cancer Patients
FRIDAY, May 24, 2024 -- The Sexual Concerns In Partners of Patients with Prostate cancer tool is a valid measure of sexual health in female partners of patients with prostate...
Transient Increase Seen in Contraceptive Use After Dobbs Decision
MONDAY, April 15, 2024 -- A transient increase in contraceptive use was seen following the Dobbs v Jackson Women's Health Organization decision, with a return to overall downward...
More news resources
- FDA Medwatch Drug Alerts
- Daily MedNews
- News for Health Professionals
- New Drug Approvals
- New Drug Applications
- Drug Shortages
- Clinical Trial Results
- Generic Drug Approvals
Subscribe to our newsletter
Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.