A review of Peyronie's disease insurance coverage.

Background

Peyronie's disease (PD) is a fibroproliferative disorder that causes an abnormal curve of the penis resulting in pain, discomfort, and erectile dysfunction with management options including correctional surgery, penile external/internal devices, shock wave therapy (SWT), intralesional Verapamil (IV), and collagenase

Aim

To investigate the insurance coverage of these treatment options.

Methods

The authors performed a cross-sectional analysis of the top US insurance policies for coverage of PD. Companies were chosen based on their market share and enrollment. Their policies were identified through a Web-based search and telephone interviews, and the companies' medical necessity criteria were defined. The online policies were then re-examined for interval change 3 years later.

Outcomes

There are significant discrepancies for in coverage for the different modalities of Peyronie's treatment.

Results

Of the 100 companies examined, only 54% of companies had a policy that directly addressed the treatment coverage for PD. The most covered treatment was CCH injections with 37 companies providing unanimous coverage (

Clinical Implications

Insurance coverage of PD should be aligned with current medical literature to better increase access to care.

Strengths & Limitations

This study is limited by the updated policies of insurance companies and future applicability. Additionally, this study assumes that a written policy will provide coverage and may overestimate the actual extent of coverage. Finally, this study only addressed some of the common treatment options of PD and did not expand on all possible treatment options.

Conclusion

Differing rates for modalities of treatment may present a barrier for patients to receive individualized and adequate treatment for PD.

Informations de copyright

Published by Oxford University Press on behalf of The International Society for Sexual Medicine 2024.

Déclaration de conflit d'intérêts

The authors have no conflict of interests to disclose.