Associations between Race and Erectile Dysfunction Treatment Patterns

Abstract Introduction: While erectile dysfunction (ED) has many available and effective treatments, the decision to elect one therapy over another depends on many variables. Whether race plays a significant role in treatment decision making is uncertain. This study seeks to investigate whether there are racial differences between men receiving treatment for ED in the United States. Methods: We performed a retrospective review using the Optum® De-identified Clinformatics® Data Mart database. Administrative diagnosis and procedural and pharmacy codes were used to identify male subjects 18 years and older with a diagnosis of ED between 2003 and 2018. Demographic and clinical variables were identified. Men with a history of prostate cancer were excluded. Types and patterns of ED treatment were analyzed after adjusting for age, income, education, frequency of urologist visits, smoking status and metabolic syndrome comorbidity diagnoses. Results: During the observation period, 810,916 men were identified who met the inclusion criteria. After matching for demographic, clinical and health care utilization factors, differences in ED treatment persisted between racial groups. Compared to Caucasians, Asian and Hispanic men had a significantly lower probability of undergoing any ED treatment, while African Americans had a higher probability of ED treatment. African American and Hispanic men had higher probabilities to undergo surgical treatment for ED than Caucasian men. Conclusions: Differences in ED treatment patterns exist across racial groups even after accounting for socioeconomic variables. An opportunity exists to further investigate potential barriers to men receiving care for sexual dysfunction.