PBS changes reduce testosterone access

blackboard says "testosterone"

Around half of all Australian men presenting to a GP with testosterone deficiency are missing out on subsidised treatment

A white paper produced by Frost & Sullivan shows that the number of men initiated with PBS-subsidised testosterone replacement therapy is estimated to have halved.

The numbers have been falling by 5,400 on an annualised basis since the introduction of changes to PBS criteria in April 2015, which lowered the serum testosterone level to qualify for subsidised treatment from 8nmol/L to 6nmol/L and required an initial consultation with a specialist to initiate treatment.

These findings are backed by a survey of 250 GPs that found only 50% of patients with testosterone deficiency commenced therapy with PBS-subsidised treatment. Meanwhile 13% of patients access treatment on private prescription, while 24% of patients do not commence therapy due to the cost and/or inconvenience now involved.

Another survey of 208 men with testosterone deficiency revealed that 48% of new patients did not commence therapy because of cost and/or inconvenience and 13% of patients who were previously receiving PBS-subsidised therapy stopped treatment due to the cost of obtaining private scripts.

The authors of the white paper conclude that the PBS restrictions were unnecessary and are leading to growing under-treatment, due to lengthy waiting periods to see specialists and associated costs, an unnecessarily restrictive testosterone threshold and the cost of private prescriptions.

The Federal Government’s Drug Utilisation Sub-Committee is set to review the impact of prescribing changes in September.

Sexual health physician Dr Graham Neilsen, from Stonewall Medical Centre in Brisbane, says he would like to see last year’s changes to testosterone PBS criteria reversed given the unnecessary burdens these restrictions have placed on men and the health system.

“Testosterone deficiency is an easily treated condition. It is well recognised that, following appropriate diagnosis, testosterone therapies can improve quality of life and reduce health complications,” he says.

“It is concerning that men are missing out on subsidised therapies either because they are unable to see a specialist or because they no longer meet the eligibility criteria.

“GPs are best placed to initiate treatment for testosterone deficiency. The PBS requirement to refer men to specialists for testosterone therapy undermines the role of GPs,” he concluded.

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