Our Priority: Advocate For the Full Continuum of Care For Prostate Cancer Survivorship

Why the Issue Matters

Many men who undertake various treatments for prostate cancer will experience significant side effects including impotence. These side effects can negatively impact a prostate cancer survivor’s quality of life and contribute to depression, anxiety, and drastically affect a marriage or partnership. Unfortunately, public and private payers have been sufficiently concerned about the financial effects of covering treatment for erectile dysfunction (ED). In 2006, Congress banned the Medicare coverage of ED medications and injectables, which caused many private insurers and self-funded health plans to follow. Then, in 2015, coverage of vacuum erection devices was halted as a result of an Inspector General report discovering that Medicare overpaid from 2006 to 2011, amounting to $14 million a year.

Patients deserve access to the full spectrum of treatment options – including prosthetic urologic interventions and reconstructive surgeries – in an attempt to restore their physical state prior to the prostate cancer treatment. Coverage decisions should be based on data and made after careful review by medical experts with a critical eye toward the impact of coverage decisions on the Medicare and veteran populations.

Fast Facts

What the AUA is Doing

Recognizing this disparity in men’s health care, the AUA worked with the American Medical Association’s (AMA) House of Delegates, which is the policymaking body of the house of medicine, to pass a measure supporting patient access to the full continuum of care of evidence-based ED treatment modalities including oral pharmacotherapy, penile vasoactive injection therapy, vacuum erection device therapy and penile prosthetics.

In addition, the AUA has worked to promote past federal measures urging protection of Medicare or veterans’ benefits for medical device treatments for male impotence that result from treatment for diseases such as prostate cancer.

And, more recently, the AUA has partnered with patient advocacy organizations such as the Men’s Health Network to urge members of Congress to pass legislation establishing a federal office of men’s health within the Department of Health and Human Services. This new entity would conduct, support, coordinate, and promote programs and activities to improve the state of male health in the United States.