03 Mar Screening Men with ED For Heart Disease May Be Cost Effective
Medical Research: What is the background for this study?
Dr. Pastuszak: The link between erectile dysfunction (ED) and cardiovascular disease (CVD) has been growing stronger in recent years, and recommendations have recently been made to screen men with ED for CVD risk factors. The arteries in the penis are much smaller than those in the heart, and if vascular disease contributes to ED, which we know it does, then ED should be detected before CVD in affected men. We also know that treating men with CVD risk factors results in improvement in their risk of having acute cardiovascular events (i.e. heart attack, stroke, etc.). Because of these relationships, we wanted to assess the economic impact of screening men with erectile dysfunction for CVD, identifying men with CVD risk factors, and treating these men on the incidence of cardiovascular events and new cases of ED. Specifically, we wanted to look at the costs associated with screening and treatment of CVD and erectile dysfunction, and the cost savings resulting from screening and treating men with CVD risk factors and ED when preventing acute cardiovascular events.
Medical Research: What are the main findings?
Dr. Pastuszak: We modeled the reduction in acute cardiovascular events and the associated cost savings over 20 years. We predicted that approximately 5.8 million men with both CVD and ED would be identified over 20 years if we screened men with ED for CVD risk factors, and the cost of this screening would be $2.7 billion. We assumed that if we treated these at-risk men, there would be an approximately 20% decrease in cardiovascular events, which would prevent 1.1 million cardiovascular events over 20 years, saving $21.3 billion that would otherwise be put to treatment of these acute events. Since ED and CVD arise from the same pathology, we predicted that in treating the CVD risk factors, a similar decrease in ED cases would be seen as well, which would save $9.7 billion that would otherwise be put to ED treatment. In screening these men, a combined $28.5 billion would be saved over 20 years.
Medical Research: What should clinicians and patients take away from your report?
Dr. Pastuszak: Our work likely highlights what many clinicians treating men with ED already suspect – that it’s more cost effective to screen these men for CVD and treat the risk factors than it is to treat the acute cardiovascular events. However, what most people, both clinicians and patients, may not realize, is just how big the difference between screening/medical treatment costs and the cost of treating acute cardiovascular events can be. We believe that this work provides further impetus for screening men with ED for CVD, with a real-dollar value attributed to the preventive benefits of screening.
With respect to patients, this work further supports how important it is for patients to understand and play a role in their health care. While it is the physician’s job to guide patients and treat their conditions, patients who are well informed can better enter into a discussion regarding their care with their physicians, and seek medical care in the first place when confronted with problems like ED, which can be a harbinger of worse disease. Thus, men who are aware of the relationship between ED and CVD stand to benefit by seeking medical care.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Pastuszak: Though not intimately related to the work performed in this study, it will be interesting to see whether treatment of CVD risk factors in men with ED truly results in improvement in ED symptoms and lowers overall ED incidence. Furthermore, the rates of ED in young men less than 40 years old are not well defined, though the rate of ED in young men may be on the rise. Having a better understanding of the number of affected younger men can help the community understand whether and how ED is linked to CVD in these younger men, particularly in light of the obesity epidemic and with other chronic diseases affecting heart health on the rise. These factors stand to further impact the physical and economic ramifications of ED.
Pastuszak, A. W., Hyman, D. A., Yadav, N., Godoy, G., Lipshultz, L. I., Araujo, A. B. and Khera, M. (2015), Erectile Dysfunction as a Marker for Cardiovascular Disease Diagnosis and Intervention: A Cost Analysis. Journal of Sexual Medicine. DOI: 10.1111/jsm.12848
MedicalResearch.com Interview with: Alexander W. Pastuszak, MD, PhD (2015). Screening Men with ED For Heart Disease May Be Cost Effective