April 14, 2015
The Journal of Sexual Medicine

TAKE-HOME MESSAGE

• This study evaluated the effect of screening men presenting with erectile dysfunction (ED) for cardiovascular disease (CVD) risk factors, as well as determined the cost-effectiveness of this screening protocol. The study utilized the known incidence and prevalence of ED and CVD, the rate of undiagnosed CVD, and the effects of CVD treatment to model the change in prevalence of acute CVD events and ED as a function of the number of men with ED and CVD. Using a relative risk of 1.47 for CVD in ED patients, the study found that approximately 6 million men with previously unrecognized CVD risk factors would be recognized over 20 years with ED/CVD screening. The model suggests the reduction in acute CVD and ED treatment cost would save $28.5 billion over 20 years.
• The authors conclude that screening for CVD in men presenting with ED can be a cost-effective intervention for secondary prevention of both CVD and, over the longer term, ED.
  – Gautam Jayram, MD

Abstract

INTRODUCTION

Erectile dysfunction (ED) is a risk factor for cardiovascular disease (CVD). We examine the costs of screening men with ED for CVD risk factors and the cost savings of treating these at risk men.

AIM

This study aims to evaluate the effect of screening men presenting with ED for CVD risk factors and to determine the cost effectiveness of this screening protocol.

METHODS

The known incidence and prevalence of ED and CVD, the rate of undiagnosed CVD, and the effects of CVD treatment were used to model the change in prevalence of acute CVD events and ED as a function of the number of men with ED and CVD. The cost savings associated with reduction in acute cardiovascular (CV) events and ED prevalence was estimated over 20 years.

MAIN OUTCOME MEASURES

Acute CVD event rate reduction and associated cost savings were modeled over 20 years.

RESULTS

The relative risk of ED in men with CVD is 1.47 and the coprevalence of both ED and CVD was estimated at 1,991,520 men. Approximately 44% of men with CVD risk factors are unaware of their risk. If all men presenting with ED were screened for CVD, 5.8 million men with previously unknown CVD risk factors would be identified over 20 years, costing $2.7 billion to screen. Assuming a 20% decrease in CV events as a result of screening and treatment, 1.1 million cardiovascular events would be avoided, saving $21.3 billion over 20 years. Similarly, 1.1 million cases of ED would be treated, saving $9.7 billion. Together, the reduction in acute CVD and ED treatment cost would save $28.5 billion over 20 years.

CONCLUSIONS

Screening for CVD in men presenting with ED can be a cost-effective intervention for secondary prevention of both CVD and, over the longer term, ED. Pastuszak AW, Hyman DA, Yadav N, Godoy G, Lipshultz LI, Araujo AB, and Khera M. Erectile dysfunction as a marker for cardiovascular disease diagnosis and intervention: A cost analysis.

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