Nelson Vergel
Founder, ExcelMale.com
TRT: Cost-effective Improvement, and Cost Savings
Through its beneficial impact on clinical parameters and risk of comorbidity, testosterone therapy also appears to be a cost-effective and cost-saving intervention. Economic models in Sweden and the UK have demonstrated the benefits of testosterone therapy on health-care systems as a whole, through its effect of reducing comorbidity risk.40,43
In Sweden, lifetime treatment of male hypogonadism with testosterone undecanoate was shown to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of €19,720 (in 2009 euros) per quality-adjusted life year, vs no treatment.43 This model incorporated the effects of testosterone undecanoate treatment on reducing risks of cardiovascular events, T2DM, fractures, depression, and death in hypothetical sample of 100,000 men with late-onset hypogonadism.43 A one-way sensitivity analysis that altered the risk of comorbidities, drug cost and age, confirmed the ICER results were robust, with changes to the risk of T2DM causing the most variation. The primary drivers of increased cost were the cost of testosterone undecanoate treatment itself, and the greater indirect cost associated with reduced mortality risk (and therefore longer survival) within the treated population; however, these increased costs were partially compensated by the reduced cost of treating comorbidities and complications.43
In the UK, treatment of male hypogonadism in males aged ≥40 with intramuscular testosterone undecanoate was also shown to have a positive cost impact, vs no treatment over a 10-year time horizon.40 This analysis included resource use and unit costs only for patients treated with IM testosterone undecanoate and calculated average direct annual costs of managing each comorbidity from the NHS national tariff in both scenarios. Across all comorbidities, a total of 408,481 patients were estimated to receive treatment with testosterone undecanoate and 913,676 patients did not receive testosterone therapy over 10 years. Overall, additional costs of drug, administration, and monitoring were outweighed by reductions in the inpatient cost of managing major comorbidities (T2DM, obesity, CVD, and osteoporosis).40 Specifically, individual yearly testosterone therapy costs of £687 were outweighed by a £3732 reduction in the yearly inpatient cost of treating comorbidities, of which approximately half was accounted for by cardiovascular disease-related cost savings (£1727) [Figure 2].40 However, this was considered to be an underestimation given possible interaction between comorbidities were not examined and the costs of drugs used to manage comorbidities were not included in this analysis.
Source:
Burden of Male Hypogonadism and Major Comorbidities, and the Clinical, Economic, and Humanistic Benefits of Testosterone Therapy: A Narrative Review
Through its beneficial impact on clinical parameters and risk of comorbidity, testosterone therapy also appears to be a cost-effective and cost-saving intervention. Economic models in Sweden and the UK have demonstrated the benefits of testosterone therapy on health-care systems as a whole, through its effect of reducing comorbidity risk.40,43
In Sweden, lifetime treatment of male hypogonadism with testosterone undecanoate was shown to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of €19,720 (in 2009 euros) per quality-adjusted life year, vs no treatment.43 This model incorporated the effects of testosterone undecanoate treatment on reducing risks of cardiovascular events, T2DM, fractures, depression, and death in hypothetical sample of 100,000 men with late-onset hypogonadism.43 A one-way sensitivity analysis that altered the risk of comorbidities, drug cost and age, confirmed the ICER results were robust, with changes to the risk of T2DM causing the most variation. The primary drivers of increased cost were the cost of testosterone undecanoate treatment itself, and the greater indirect cost associated with reduced mortality risk (and therefore longer survival) within the treated population; however, these increased costs were partially compensated by the reduced cost of treating comorbidities and complications.43
In the UK, treatment of male hypogonadism in males aged ≥40 with intramuscular testosterone undecanoate was also shown to have a positive cost impact, vs no treatment over a 10-year time horizon.40 This analysis included resource use and unit costs only for patients treated with IM testosterone undecanoate and calculated average direct annual costs of managing each comorbidity from the NHS national tariff in both scenarios. Across all comorbidities, a total of 408,481 patients were estimated to receive treatment with testosterone undecanoate and 913,676 patients did not receive testosterone therapy over 10 years. Overall, additional costs of drug, administration, and monitoring were outweighed by reductions in the inpatient cost of managing major comorbidities (T2DM, obesity, CVD, and osteoporosis).40 Specifically, individual yearly testosterone therapy costs of £687 were outweighed by a £3732 reduction in the yearly inpatient cost of treating comorbidities, of which approximately half was accounted for by cardiovascular disease-related cost savings (£1727) [Figure 2].40 However, this was considered to be an underestimation given possible interaction between comorbidities were not examined and the costs of drugs used to manage comorbidities were not included in this analysis.
Source:
Burden of Male Hypogonadism and Major Comorbidities, and the Clinical, Economic, and Humanistic Benefits of Testosterone Therapy: A Narrative Review
