(169) Characteristics of Telehealth Platforms Offering Erectile Dysfunction Treatment
Authors: Brink S , Iarajuli T , Shin D 
Published: May 2023

Abstract

Introduction
Telehealth platforms are becoming more prevalent in the field of medicine, including men’s sexual health. Due to the sensitivity and potential embarrassment of discussing erectile dysfunction (ED) issues in-person, men may seek alternative methods to obtain ED treatment without leaving their homes.

Objective
We sought to compare the offerings of telehealth platforms for ED treatment with respect to consultation, price, services provided, and privacy policy.

Methods
Google was queried in June 2022 to identify online telehealth platforms offering ED treatment. Two reviewers identified and analyzed the top 50 results using the keywords “telehealth erectile dysfunction,” “telemedicine erectile dysfunction,” and “online erectile dysfunction.” Inclusion criteria are as follows: platforms must serve a majority of US states, exist online-only, provide both the consultation and prescription for phosphodiesterase 5 inhibitors (PDE5i), and deliver the prescription to the patient. Descriptive analysis of pricing information, physician access, and HIPAA compliance was performed.

Results
Fifteen online platforms met inclusion criteria. Ten provided “free” consultations; however, patients were expected to pay monthly or quarterly fees for prescriptions. Four bundled the consultation fee with the first month of the prescription; one of these functioned as a subscription service with a $10 monthly charge plus monthly refill fee. Fourteen (93%) platforms began the consult with an online form and ten (67%) platforms advertised review by the prescriber within two business days. Four (33%) platforms explicitly advertised physician-only consults, five (27%) used the vague term “provider,” and the remaining six (40%) advertised either physicians or other prescribers on staff. Direct contact with the prescriber (digital/audio/video) would only occur if needed or if required by state law at eight (53%) platforms. The ability to directly purchase sildenafil and tadalafil was advertised on all platforms. Pricing information varied depending on pill strength and quantity ordered on eight platforms. Six platforms only offered pricing per dose without specifying medication strength. Minimum prices of sildenafil ranged from $0.99-35/pill (mean $5.37/pill, median $2.50/pill) while tadalafil ranged from $0.90-44/pill (mean $8.48/pill, median $6/pill). In addition to ED therapy, thirteen (86%) platforms offered treatment for other men’s health issues such as premature ejaculation or hair loss. All platforms included a privacy policy, but only ten (66%) mentioned HIPAA compliance with two of these claiming to not be “covered entities.”

Conclusions
Telehealth platforms are changing the face of healthcare to offer evaluation and treatment of health conditions, including ED, privately from the patient’s own home. Although platforms are transparent with PDE5i medication and subscription pricing information, very few offer direct contact with a physician to further discuss issues related to ED after completion of the online intake form. For patients seeking a more comprehensive evaluation for their ED in a HIPAA compliant setting, a formal in-person or telemedicine visit should be arranged with their physician.

Disclosure
No