Morton Andrew, Williams Michael, Perera Marlon, Ranasinghe Sachinka, Teloken Patrick E, Williams Marissa, Chung Eric, Roberts Matthew J
Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia.
World J Mens Health. 2021 Jan;39(1):83-89. doi: 10.5534/wjmh.190166. Epub 2020 Jul 30.
Testosterone replacement therapy (TRT) is commonly used for various causes of androgen deficiency and subsidized by the Pharmaceutical Benefits Scheme (PBS) in Australia when appropriate. In response to a sharp increase in the prescribing of subsidized TRT, the Australian government instituted new, stricter prescription criteria in April 2015. We aim to demonstrate longitudinal changes in the prescription patterns of subsidized TRT over time.
The publicly available PBS database was accessed for TRT prescription data between 1992-2018. Population estimate data was collected from the Australian Bureau of Statistics for population-adjustment. Data analysis was performed according to class and specific formulation of TRT. Total and population-adjusted trends were considered, as was indexation to 2015 when restrictions were implemented.
Longitudinal trends in subsidized TRT prescription demonstrated a progressive overall increase since 2000, according to total prescriptions and population-adjusted estimates, with greater use of topical formulations (gel, patch, cream/spray) and injections. Since 2015, a 37% decline in total population-adjusted prescriptions was observed (1,399-883 per 100,000 persons). Since 2015, relatively increased use of injections (50%) and 1% gel (30%) comprise the majority of contemporary TRT. Annual financial burden due to TRT was $AU16,768 per 100,000 persons prior to 2000 (mean cost 1992-2000), increasing to $AU112,539 in 2018 (due to use of injections). The rate of change in costs slowed after the restrictions were introduced in 2015.
The restrictions in subsidized TRT eligibility enforced by the PBS have reduced overall TRT prescriptions and slowed the cumulative financial burden.
睾酮替代疗法（TRT）常用于各种雄激素缺乏症，在澳大利亚，若适用，可由药品福利计划（PBS）提供补贴。鉴于补贴TRT处方量急剧增加，澳大利亚政府于2015年4月制定了新的、更严格的处方标准。我们旨在展示补贴TRT处方模式随时间的纵向变化。
访问公开的PBS数据库，获取1992 - 2018年期间的TRT处方数据。从澳大利亚统计局收集人口估计数据用于人口调整。根据TRT的类别和具体剂型进行数据分析。考虑了总量和人口调整后的趋势，以及2015年实施限制措施后的指数化情况。
根据总处方量和人口调整后的估计数，补贴TRT处方的纵向趋势显示，自2000年以来总体呈逐步上升趋势，局部用剂型（凝胶、贴片、乳膏/喷雾剂）和注射剂的使用更为频繁。自2015年以来，观察到经人口调整后的总处方量下降了37%（每10万人从1399例降至883例）。自2015年以来，注射剂（50%）和1%凝胶（30%）使用量的相对增加构成了当代TRT的主要部分。2000年之前，每10万人因TRT产生的年度财务负担为16768澳元（1992 - 2000年的平均成本），到2018年增至112539澳元（由于使用注射剂）。2015年实施限制措施后，成本变化率放缓。
PBS对补贴TRT资格的限制减少了总体TRT处方量，并减缓了累积财务负担。
