Current stepwise recommendations for hypogonadism screening in erectile dysfunction are not cost-effective

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Morgado, A (Author) Other; Moura, ML (Author) Other; Paulo Dinis (Author) FMUP; Carlos Silva (Author) FMUP

Journal

Title: International Journal of Impotence Research

Vol. 32

Pages: 297-301

ISSN: 0955-9930

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 1 Citation

Other information

Authenticus ID: P-00S-5GZ

DOI: 10.1038/s41443-019-0169-0

Abstract (EN): Hypogonadism is a prevalent comorbidity with erectile disfunction (ED) and current guidelines recommend screening for hypogonadism with total testosterone (TT). If low TT is detected, further assessment with LH and SHBG plus albumin are needed to establish an etiology and treatment. Our primary objective was to determine the cost benefit of current stepwise approach versus ad initium full hormonal assessment. Two hundred consecutive male patients referred for ED were screened after consent and 81 were included and assessed for hypogonadism according to the current stepwise approach with TT, and only if TT was less than 345 ng/mL, a full hormonal assessment with TT, LH, and SHBG plus albumin to calculate free testosterone was performed. Direct costs were calculated using the national public healthcare system reimbursement tables and were compared with a hypothetical initial full hormonal assessment. Screening TT was less than 345 ng/mL in 34.6% patients leading to a full hormonal assessment on these. Using a stepwise approach there was a direct cost increase of 5.82 euro per patient. Moreover, one out of every three patients had two extra venipunctures and an additional follow-up appointment. Current stepwise recommendations may prove costly in high prevalence scenarios such as the ED subpopulation as a direct cost increase was observed.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5