Objective: The objective of this study was to estimate the annual socioeconomic burden imposed by erectile dysfunction (ED) on UK society. Design and Setting: Health service resource use attributable to ED during 1997/1998 was obtained from appropriate databases and a panel of 22 hospital specialists comprising urologists, genito-urinary physicians, diabetologists and sexual health physicians. National unit resource costs at 1996/1997 prices were applied to the resource use data to estimate the annual National Health Service (NHS) cost of managing ED. A structured questionnaire pertaining to direct costs and absenteeism from work attributable to ED was mailed to a randomly selected sample of 5000 individuals who experience ED. Main outcome measures and results: During 1997/1998, the annual NHS cost was estimated to be Lstg 43.8 million for managing 113 600 men with ED. Outpatient visits were the major cost driver, accounting for 65% of the annual cost. Drugs prescribed by general practitioners (GPs) accounted for a further 25%. GP consultations and penile prosthetic surgery each accounted for 4%. Tests initiated by GPs accounted for 2%, while other resources accounted for less than 1%. The annual cost was sensitive to the number of outpatient visits and, to a lesser extent, to the number of prescriptions for ED treatments, but insensitive to changes in use of the other resources. Completed questionnaires were received from 23% (n = 1141) of the sample of individuals who experience ED. From the survey, it was estimated that the NHS managed 35% of individuals with ED in the last year. Assuming this to be representative, the total potential population of individuals with ED in the UK was estimated to be approximately 324 600 men. The total population of individuals with ED (n = 324 600 men) was estimated to incur Lstg 7.0 million annually in direct costs attributable to ED and to lose 19 630 days a year from work as a result of their ED, costing society Lstg 2.2 million in lost gross domestic product. Conclusions: ED imposes a relatively small burden on UK society - Lstg 53 million. Of this, 83% is borne by the NHS and 13% by patients. Indirect costs to society due to lost productivity account for the remaining 4%. The total NHS cost is strongly influenced by the number of hospital outpatient visits. Therefore, the future burden will depend largely on patients' eligibility to receive ED treatments on the NHS.
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