In Canada, between January and October of 2019, there were 524,753 TRT prescriptions, a growth of 4% over the same time period in 2018.
Topical treatments represent 47.4%, oral treatments represent 18.2%, and injectable treatments represent 34.4% of the total prescription TRT market between January and October of 2019. The prescription growth between January and October 2019 over the same time period in 2018 for each of these categories saw a decrease of 0.9% for topical treatments, a decrease of 7.5% for oral treatments, and an increase of 13.4% for injectable treatments. The issuance of updated Canadian TRT Guidelines (diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline) at the end of 2015 has re-established confidence in the safety of this class of medicines and helped to increase total prescription growth in the TRT market in 2017, 2018 and the first 10 months 2019 compared to the same time period in 2018. The increase in prescriptions seen in 2018 for the TRT market was the fourth consecutive year of growth.
In Canada, sales of total TRT products for 2018 were CDN$64.6 million with an increase of 3.47% from 2017. Topical products made up 73% of all dollar sales in the TRT market. In Canada, sales of total TRT products for six months ending June 2019 were CDN$33.1million with an increase of 5.4% from the first six months in 2018.
Canada Competitive Landscape
AndroGel® (BGP Pharma ULC, a division of Mylan) is the most prescribed TRT product in Canada followed by injectables and orals.
At present, there are only one-third party generic topical TRT products available in Canada. The generic version of AndroGel®, Taro-Testosterone (Taro Pharmaceuticals Inc.) became available in November 2017.
Axiron® (Lilly) was discontinued for sales in Canada as of December 2017. Both Xyosted® and Jatenzo® have not been approved or available for sale in Canada at this time.
Health Canada has also added black box warnings to all marketed topical gel testosterone products with regards to secondary exposure to testosterone. Natesto®’s product monograph does not include the black box warning related to secondary transference, which is required for all other topical gel testosterone products.
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