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A UK epidemic of testosterone prescribing, 2001–2010
Author(s) -
Gan Earn H.,
Pattman Stewart,
H. S. Pearce Simon,
Quinton Richard
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12178
Subject(s) - testosterone (patch) , medicine , context (archaeology) , medical prescription , testosterone replacement , pharmacy , erectile dysfunction , endocrinology , gynecology , androgen , family medicine , pharmacology , hormone , biology , paleontology
Summary Context Testosterone replacement therapy is the standard treatment for male hypogonadism. There has lately been increased marketing in the medical media promoting testosterone replacement for men with erectile dysfunction or for older men with low serum testosterone, despite the lack of long‐term safety and efficacy data. Therefore, we aimed to examine trends in testosterone prescribing in UK primary care over the last 10 years. Methods Data about the use of testosterone preparations from the D epartments of H ealth P rescription C ost A nalysis for community pharmacies 2001–2010, for E ngland, S cotland and W ales, were collated. C ommunity requests for serum total testosterone assay in men to the B iochemistry D epartment at the N ewcastle upon T yne H ospitals T rust were also examined over the same time period. Results The number of prescriptions for testosterone preparations increased by nearly 90% from 157 602 to 298 134 dispensed items annually, over a 10‐year period. However, due to a particularly significant (fivefold) increase in prescribing of (more expensive) transdermal preparations, the cost to the NHS showed a 267% escalation, from £3·2 to £11·7 million, annually over the same period. Local requests from primary care in the N ewcastle and N orth T yneside area for serum testosterone measurement in men also increased, from 347 requests in 2000 to 823 requests in 2010, a 137% increase. However, the number of men with likely unequivocal hypogonadism (testosterone less than 6·0 n m ) remained constant at 5·2% in 2000 and 6·3% in 2010. Conclusion Many men in the UK might be receiving testosterone replacement therapy with neither clearly established indications nor robustly diagnosed hypogonadism. A national registry for men treated with testosterone and further evidence to improve current guidance (national and/or international) on the indications for testosterone replacement would be beneficial.