(240) CONTEMPORARY PEYRONIE’S DISEASE MANAGEMENT AND PAYER’S PROFILE IN A HIGH-VOLUME MEN’S HEALTH CENTER
Authors: Furtado T , Loeb C , Bash J , Amis JM , Jayadevan R , Eleswarapu S , Mills JN 
Published: December 2024

Abstract

Introduction
Collagenase C. histolyticum (CCH) was approved by the FDA for Peyronie’s Disease (PD) treatment in 2013. CCH has become a mainstay in the nonsurgical treatment of PD, and is typically covered by insurance companies for treatment of penile curvature between 30° and 90°. Other than observation, treatments for PD are mostly surgical and include penile plication, plaque excision/incision and graft (PEG), and penile implant. Choice of treatment is greatly influenced by surgeon experience and shared decision-making with patients.

Objective
This abstract aims to report the management and billing demographics profile of high volume andrology center specializing in PD treatment since the advent of CCH.

Methods
Data were obtained from a single surgeon’s experience on patients with PD from 2016 to 2024 at a high volume academic center in the United States. The data were analyzed to create a profile of how PD is managed in contemporary practice.

Results
We identified 2,137 unique patients from 2016 to 2024 by the ICD10 code for PD diagnosis (N48.6) at this institution. The surgeon analyzed here is solely responsible for 1,863 unique patients. The majority of patients (78.7%) were between 45 and 74 years of age. The majority of patients self-identified as white (65.2%) and non Hispanic/Latinx (69.1%). Protocol in this clinic is to offer all treatment options, including observation/medical management with PDE 5 inhibitors, intralesional injection therapy and surgery, to all patients and engage in shared decision making. At least one CCH injection was performed in 805 patients (43.2%), with a median of 8 (IQR 8-16) injections per patient. Of those, 614 (76%) completed at least one round of CCH treatment (8 injections) or more (359; 45%). Surgical management was involved in 143 patients (7.7%), of which 30 underwent penile plication (1.6%), PEG in 72 (3.8%), and penile prosthesis with or without adjunct straightening procedures in 43 (2.3%). Of the patients who underwent surgical management, 40 (28.8%) had at least one injection of CCH prior. Of those patients, the median injections prior to surgical procedure was 10 (IQR 8-16). No treatment other than medical management was involved in 49% of patients in this cohort. Payer mix was most commonly a commercial insurance plan (58%), with public payers (Medicare and Medi-Cal) representing the second largest payer (29%). Other payers were 9% institutional managed care and referred medical groups and less than 1% self-pay. The remainder were unspecified as “other” and may include international patients.

Conclusions
The large cohort included in this profile analysis represents one of the largest in the literature. This extensive demographic and treatment profile provides valuable insights into the contemporary management and billing practices at a high-volume academic men’s clinic, with the hopes of better understanding current PD management and informing future clinical practices.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Endo Pharmaceuticals and Halozyme Therapeutics.