Testosterone Gel Adherence Low Among Hypogonadal Men

[Nelson Vergel]

Fewer than one in five hypogonadal men are adherent to prescribed topical testosterone, new research indicates.

The findings, from a large commercial insurance database, were presented May 5 here at the American Association of Clinical Endocrinologists (AACE) 2017 Annual Scientific & Clinical Congress by Michael Grabner, PhD, of HealthCore, Wilmingon, Delaware.

Among a total of 3184 men with primary or secondary hypogonadism who had filled a prescription for topical testosterone therapy of any kind (brand-name or generic), just 17% were defined as adherent. And over 1 year, 81% of the men discontinued treatment.

These results are similar to two other studies for which data were collected in 2009, Dr Grabner told Medscape Medical News. "Adherence is still suboptimal. We're, way, way off.…It's been 7 years, and we're still pretty low."

Asked to comment, AACE president Jonathan D Leffert, MD, of North Texas Endocrine Center, Dallas, called the results "unfortunate, but not terribly surprising, from my experience." One of the problems, he noted, is that many men don't think of hypogonadism as a chronic condition.

"Hypogonadism, if it's truly diagnosed correctly, is a chronic disease just like diabetes, hypertension, or hyperlipidemia.…Some people think that 'if I just get that jump-start I'll be better, I'll feel better, and then I can just stop it and go on,' but that's not reality."

Thus, Dr Leffert advised, "When you start treating patients, you have to clearly say this is something you're going to be taking essentially for a lifetime if that's really the case."

And of course, he and Dr Grabner both pointed out, the cost of the medications may be another factor, as well as concerns about adverse effects.

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[Dr Justin Saya MD]

Part of it, I'm certain, is the confounder of most transdermals being underdosed and (consequently) very ineffective. However, even with appropriately dosed and effective transdermals compliance can be an issue for various reasons.

 

[Vince Carter]

Big Pharma's products, Androgel 1.62 in particular are wildly expensive, too, I became noncompliant and forced to change because of it, there was no way I could stomach $142/2 weeks and that was insurance picking up 50%.

 

[Vitamin_C]

I've been looking at a lot of studies on Testosterone for grad school and the data I've seen is most men prefer the gel over shots as they feel shots are too invasive. Personally, I am kicking the tires on going back to a high dosed gel through Empower at my next meeting with my TRT physician in October. I am dialed in with my injection regime and feel good but I liked applying the gel daily as weird as that sounds. I came off the gel because my TT wasn't getting above 500 ng/dl but I was on a pretty conservative dose at the time.

 

[CoastWatcher]

I've been looking at a lot of studies on Testosterone for grad school and the data I've seen is most men prefer the gel over shots as they feel shots are too invasive. Personally, I am kicking the tires on going back to a high dosed gel through Empower at my next meeting with my TRT physician in October. I am dialed in with my injection regime and feel good but I liked applying the gel daily as weird as that sounds. I came off the gel because my TT wasn't getting above 500 ng/dl but I was on a pretty conservative dose at the time.

Gels failed to work for me. Injecting on a daily basis for over two years has brought great success. I find the process of daily injections preferable to daily gel application.