The Testosterone Project, a Raleigh, N.C.-based nonprofit, released a policy brief Aug. 11 estimating that undiagnosed testosterone deficiency in U.S. men ages 45 to 74 could be linked to $190 billion to $525 billion in direct healthcare spending over 20 years.
The report, “The Hidden Cost of Missed Testosterone Deficiency,” attributes roughly $8.4 billion in costs to the first year alone. Men newly diagnosed with hypogonadism incurred about $2,821 more in annual direct medical spending than matched controls, and privately insured employees with the condition carried roughly $4,869 more per year in combined direct and workforce costs.
The brief also cites the T4DM trial, which found testosterone therapy plus lifestyle intervention cut a two-year diabetes endpoint from 21% to 12% among high-risk men. The TRAVERSE trial, involving 5,246 men, found testosterone therapy noninferior on major adverse cardiovascular events, addressing a safety concern that had limited treatment conversations for over a decade.
“Testosterone deficiency hides beneath conditions that already dominate men’s healthcare spending: diabetes, metabolic syndrome, obesity, unexplained anemia, fatigue, and depressed mood,” said Mohit Khera, MD, professor of urology at Baylor College of Medicine and a spokesperson for the nonprofit. “The men with the strongest case for evaluation are often the ones who never get tested.”
The brief calls for targeted case-finding among symptomatic men rather than universal screening, and advocates descheduling testosterone from Schedule III, approving testosterone formulations for women, and formally recognizing testosterone deficiency as a medical condition.
Read the full report here.
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