ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2012 Jun 4;196(10):642-5. doi: 10.5694/mja11.11277.
To describe patterns of testosterone prescribing in Australia over the past two decades by state or territory and by product type.
Observational analysis of testosterone prescribing data obtained from two independent data sources--the Pharmaceutical Benefits Scheme (PBS) and IMS, a source of commercial pharmaceutical sales data.
Temporal trends in testosterone prescribing--measured as units prescribed (converted into monthly defined doses) and expenditure--to state or territory and product type (injectable, implantable, transdermal and oral).
Over two decades, total annual expenditure on testosterone products increased ninefold to $12.7 million according to PBS data and fivefold to $16.3 million according to IMS data. When adjusted for inflation and population growth, expenditure increased 4.5-fold according to PBS data and 2.5-fold according to IMS data. The patterns of testosterone prescribing according to PBS and IMS data were highly congruent. When converted into monthly defined dose units, testosterone prescribing increased over the two decades with approximately twofold differences in total testosterone prescribed per capita between the states and territories with the highest and lowest rates of prescribing. When analysed by product type, the stable market patterns over the first 15 years were disrupted by sharp changes to create market dominance owing to introduction of two new testosterone products--a depot injectable testosterone and a transdermal testosterone gel.
The progressive increase in PBS-subsidised testosterone prescribing without changes in proven medical indications or improvements in diagnosis of pathologically based androgen deficiency are likely to be due to promotion-driven non-compliance with PBS prescribing criteria, indicating that more effective implementation of the criteria is needed.
描述过去二十年中澳大利亚按州或地区以及产品类型开处睾酮的模式。
从两个独立的数据源——药品福利计划（PBS）和 IMS（商业药品销售数据来源）获取睾酮处方数据，进行观察性分析。
按州或地区和产品类型（注射、植入、透皮和口服）规定的睾酮处方数量（换算为每月规定剂量）和支出的时间趋势。
根据 PBS 数据，过去二十年中，睾酮产品的年总支出增加了九倍，达到 1270 万美元，根据 IMS 数据，支出增加了五倍，达到 1630 万美元。经通胀和人口增长调整后，PBS 数据显示支出增加了 4.5 倍，而 IMS 数据则增加了 2.5 倍。根据 PBS 和 IMS 数据，睾酮处方的模式高度一致。按每月规定剂量单位换算，过去二十年中，睾酮处方量增加，处方率最高和最低的州和地区之间，人均睾酮处方量差异约为两倍。按产品类型分析，前 15 年稳定的市场模式因两种新的睾酮产品（一种注射用睾酮制剂和一种透皮睾酮凝胶）的推出而发生急剧变化，从而打破了市场主导地位。
PBS 补贴的睾酮处方数量不断增加，但未改变已证实的医学适应证或改善基于病理的雄激素缺乏症的诊断，这可能是由于促销驱动的不遵守 PBS 处方标准所致，表明需要更有效地执行这些标准。
