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Patterns of testosterone prescription overuse.

Guneet K Jasuja1, Shalender Bhasin, Adam J Rose

  • 1aCenter for Healthcare Organization and Implementation Research (CHOIR), ENRM VAMC, Bedford. bDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston cResearch Program in Men's Health, Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston dRAND Corporation, Boston, MA eDepartment of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.

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Testosterone therapy prescribing has increased, but often lacks appropriate diagnostic evaluation and is used for unproven conditions. Improvements in testosterone prescribing practices are needed.

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Men's Health

Background:

  • Testosterone therapy prescribing has risen significantly over the past decade.
  • Concerns exist regarding the influence of advertising on testosterone prescription trends.
  • Medical practice and adherence to guidelines are key considerations.

Purpose of the Study:

  • To review recent trends in testosterone prescribing.
  • To evaluate the appropriateness of testosterone prescription based on established guidelines.

Main Methods:

  • Analysis of global and U.S. data on testosterone use.
  • Examination of diagnostic evaluations preceding testosterone prescriptions.
  • Assessment of conditions for which testosterone therapy is prescribed.

Main Results:

  • Overall increase in testosterone use globally and in the U.S. in the last decade.
  • Early indications of declining testosterone sales since 2014.
  • Increased testosterone prescriptions without recommended diagnostic evaluations and for unproven conditions.

Conclusions:

  • Current testosterone prescribing practices present opportunities for improvement.
  • Further understanding of provider- and system-level factors is necessary to enhance prescribing.
  • Optimizing testosterone therapy requires adherence to guidelines and appropriate patient selection.