The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.

<h4>Background</h4>Despite a lack of data describing the long-term efficacy and safety of testosterone replacement therapy (TRT), prescribing of testosterone to older men has increased with the availability of topical formulations. The magnitude of this increase and the impact of formula...

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Autores principales:	Jolanta Piszczek, Muhammad Mamdani, Tony Antoniou, David N Juurlink, Tara Gomes
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6d43153f73684af6b5c7ce4327e66d57
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spelling	oai:doaj.org-article:6d43153f73684af6b5c7ce4327e66d572021-11-25T06:08:20ZThe impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.1932-620310.1371/journal.pone.0098003https://doaj.org/article/6d43153f73684af6b5c7ce4327e66d572014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25029014/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Despite a lack of data describing the long-term efficacy and safety of testosterone replacement therapy (TRT), prescribing of testosterone to older men has increased with the availability of topical formulations. The magnitude of this increase and the impact of formulary restrictions on testosterone prescribing are poorly characterized.<h4>Methods</h4>We conducted a time series analysis using the linked health administrative records of men aged 66 years or older in Ontario, Canada between January 1, 1997 and March 31, 2012. We used interventional autoregressive integrated moving average models to examine the impact of a restrictive drug reimbursement policy on testosterone prescribing and examined the demographic profile of men initiating testosterone in the final 2 years of the study period.<h4>Results</h4>A total of 28,477 men were dispensed testosterone over the study period. Overall testosterone prescribing declined 27.9% in the 6 months following the implementation of the restriction policy (9.5 to 6.9 men per 1000 eligible; p<0.01). However, the overall decrease was temporary and testosterone use exceeded pre-policy levels by the end of the study period (11.0 men per 1000 eligible), largely driven by prescriptions for topical testosterone (4.8 men per 1000 eligible). Only 6.3% of men who initiated testosterone had a documented diagnosis of hypogonadism, the main criteria for TRT reimbursement according to the new policy.<h4>Conclusion</h4>Government-imposed restrictions did not influence long-term prescribing of testosterone to older men. By 2012, approximately 1 in every 90 men aged 66 or older was being treated with TRT, most with topical formulations.Jolanta PiszczekMuhammad MamdaniTony AntoniouDavid N JuurlinkTara GomesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e98003 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jolanta Piszczek Muhammad Mamdani Tony Antoniou David N Juurlink Tara Gomes The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
description	<h4>Background</h4>Despite a lack of data describing the long-term efficacy and safety of testosterone replacement therapy (TRT), prescribing of testosterone to older men has increased with the availability of topical formulations. The magnitude of this increase and the impact of formulary restrictions on testosterone prescribing are poorly characterized.<h4>Methods</h4>We conducted a time series analysis using the linked health administrative records of men aged 66 years or older in Ontario, Canada between January 1, 1997 and March 31, 2012. We used interventional autoregressive integrated moving average models to examine the impact of a restrictive drug reimbursement policy on testosterone prescribing and examined the demographic profile of men initiating testosterone in the final 2 years of the study period.<h4>Results</h4>A total of 28,477 men were dispensed testosterone over the study period. Overall testosterone prescribing declined 27.9% in the 6 months following the implementation of the restriction policy (9.5 to 6.9 men per 1000 eligible; p<0.01). However, the overall decrease was temporary and testosterone use exceeded pre-policy levels by the end of the study period (11.0 men per 1000 eligible), largely driven by prescriptions for topical testosterone (4.8 men per 1000 eligible). Only 6.3% of men who initiated testosterone had a documented diagnosis of hypogonadism, the main criteria for TRT reimbursement according to the new policy.<h4>Conclusion</h4>Government-imposed restrictions did not influence long-term prescribing of testosterone to older men. By 2012, approximately 1 in every 90 men aged 66 or older was being treated with TRT, most with topical formulations.
format	article
author	Jolanta Piszczek Muhammad Mamdani Tony Antoniou David N Juurlink Tara Gomes
author_facet	Jolanta Piszczek Muhammad Mamdani Tony Antoniou David N Juurlink Tara Gomes
author_sort	Jolanta Piszczek
title	The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
title_short	The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
title_full	The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
title_fullStr	The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
title_full_unstemmed	The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
title_sort	impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/6d43153f73684af6b5c7ce4327e66d57
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The impact of drug reimbursement policy on rates of testosterone replacement therapy among older men.

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