Mp47-20 Trends in Prices for Testosterone Replacement Therapy in the United States, 2018-2022

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I (MP47)1 May 2024MP47-20 TRENDS IN PRICES FOR TESTOSTERONE REPLACEMENT THERAPY IN THE UNITED STATES, 2018-2022 Thomas Hwang, John Ernandez, Brittany Berk, and Martin Kathrins Thomas HwangThomas Hwang , John ErnandezJohn Ernandez , Brittany BerkBrittany Berk , and Martin KathrinsMartin Kathrins View All Author Informationhttps://doi.org/10.1097/01.JU.0001008880.11564.10.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testosterone replacement therapy (TRT) is indicated for treatment of limiting symptoms of hypogonadism. Over the past two decades, prescriptions for TRT have increased substantially in the United States, due partly to aging population as well as increased consumer and prescriber marketing. During this period, new formulations of testosterone, including topical gels and tablets, have also made TRT more convenient. However, it remains unclear how the pricing and market for TRT has changed in recent years. The objective of this study was to evaluate trends in retail pharmacy prices for TRT from 2018-2022. METHODS: We identified all manufacturers and unique formulations of TRT at the package-strength level based on national drug codes (referred to herein as drugs) and marketed in the United States from 2018-2022. For each product, we then extracted all available prices (weekly) during the study period using the national average drug acquisition cost, which is based on a national survey of retail community pharmacy prices published by the Centers for Medicare and Medicaid Services. We calculated median and annualized percentage price changes with and without adjustment for inflation (Consumer Price Index from the Bureau of Labor Statistics). We also used linear regression to assess the association between logarithmically-transformed prices and time, adjusted for clustering by manufacturer. Statistical significance was defined as two-tailed p<0.05. RESULTS: There were 73 TRT products marketed by 28 manufacturers and associated with 10,406 pricing datapoints reported from 2018-2022. Overall, the unweighted retail price of TRT decreased significantly during the study period (p=0.039 unadjusted; p=0.012 adjusted). The median unadjusted total and annual percent price changes were -12.3% (interquartile range [IQR]: -27.3% to 0.1%) and -4.2% (IQR: -8.1% to 0%), respectively. The greatest price decrease was for a generic topical formulation of testosterone (-87.3% overall and -30.6% average decrease annually), and the greatest price increase was for a subcutaneous formulation (+16.1% overall and 5.4% annual average). Adjusted for inflation, the median total and annual percent price changes were -24.8% (IQR: -35.9% to -12.0%) and -7.5% (IQR: -10.6% to -3.8%), respectively. CONCLUSIONS: The retail pharmacy price of TRT decreased significantly, on average, from 2018-2022, though there was variation between formulations. Sustainable generic competition requires participation from multiple manufacturers, and market dynamics should be carefully monitored. Source of Funding: Departmental © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e771 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Thomas Hwang More articles by this author John Ernandez More articles by this author Brittany Berk More articles by this author Martin Kathrins More articles by this author Expand All Advertisement PDF downloadLoading ...