MARKETING AND TESTOSTERONE TREATMENT IN THE UNITED STATES

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life & Shared Decision Making I1 Apr 2018MP44-09 MARKETING AND TESTOSTERONE TREATMENT IN THE UNITED STATES Jathin Bandari, Omar Ayyash, Sherry Emery, Charles Wessel, and Benjamin Davies Jathin BandariJathin Bandari More articles by this author , Omar AyyashOmar Ayyash More articles by this author , Sherry EmerySherry Emery More articles by this author , Charles WesselCharles Wessel More articles by this author , and Benjamin DaviesBenjamin Davies More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1428AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testosterone replacement therapy (TRT) is currently only Food and Drug Administration approved for classic hypogonadism, though off-label indications have resulted in a dramatic expansion in prescriptions in the United States. Marketing may significantly affect prescriber behavior. Our study sought to systematically review all available evidence on marketing and testosterone replacement therapy in the United States. METHODS PubMed, Embase, and Scopus were systematically searched up to July 2017 for all relevant publications reporting on assessments of the TRT market size, economic costs associated with hypogonadism, trends in TRT prescriptions, drug discontinuation rates, and advertising and sales efforts in the United States. RESULTS Twenty retrospective studies were included in the final analysis (Figure 1). The market size for hypogonadism constitutes 5.6% to 76.8% of men in the United States, with the lower end of the range representing the strictest criteria for diagnosis. Men with diagnosis of hypogonadism consume $14,118 in direct and indirect costs to the payer. Over the last two decades, TRT prescriptions have increased between 1.8 and 4-fold. After 1 year, 80% to 85% of men discontinue TRT. There is an association between direct-to-consumer advertising and testosterone testing, TRT prescriptions, and TRT without testosterone testing. There is a high prevalence of misinformation on internet advertising. CONCLUSIONS Off-label indications have driven the dramatic expansion of testosterone replacement therapy prescriptions over the last two decades. Direct-to-consumer advertising poses a unique challenge in the United States. Overtreatment can be avoided by applying strict diagnostic criteria for hypogonadism, which limits the addressable market for TRT. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e590-e591 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jathin Bandari More articles by this author Omar Ayyash More articles by this author Sherry Emery More articles by this author Charles Wessel More articles by this author Benjamin Davies More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...