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Feb 01, 2022
5 min read

Testosterone replacement therapy cost: what to expect

 

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

If you’re experiencing low testosterone (low T) or gender dysphoria symptoms, your healthcare provider may recommend testosterone replacement therapy. 

While this can bring a sense of relief, it may also cause anxiety about cost. How much does testosterone replacement therapy cost? That depends on a few variables. Let’s take a look at what impacts cost and compare testosterone therapy prices below.

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How much does testosterone replacement therapy cost?

As with all medications, the cost of testosterone replacement therapy (TRT) varies depending on the treatment you choose. It also depends on the state you live in, your pharmacy, insurance plan, and any potential discounts available. 

Keep in mind that some forms of TRT may not be covered or will be subject to a co-pay. Generic forms may also be cheaper if available. The following are average approximate retail prices of various TRT treatment options in New York.

Testosterone patch

The most common treatment for low T is testosterone patches, which are applied to the skin. Currently, there is one testosterone patch on the market:

  • AndroDerm patch (4 mg, 30 patches, one-month supply): $734 (GoodRx, n.d.-a)

Testosterone gel

A frequently prescribed treatment, testosterone gels are rubbed into the skin. There are several options available:

  • AndroGel (1 gel pump, 88 g, 1.62%): $736 (generic: $468) (GoodRx, n.d-b.)
  • Testim (5 g of 50 mg, 30 tubes, one-month supply): $735 (generic: $453) (GoodRx, n.d.-c)
  • Fortesta (60 g of 10 mg, 1 pump): $499 (generic: $401) (GoodRx, n.d.-d)
  • Vogelxo (5 g of 50 mg, 30 packets, one-month supply): $460 (generic: $453)
    (GoodRx, n.d.-e)

Testosterone solution

This topical treatment is rubbed onto the skin, usually twice a day. 

  • Axiron (90 mL of 30 g, one bottle): Available as generic $539 (GoodRx, n.d.-f)

Nasal testosterone

Nasal testosterone gel is applied to the inside of each nostril three times a day.

  • Natesto (11 g of 5.5 mg, one tube): $344 (no generic available) (GoodRx, n.d-g).

Injectable testosterone

There are currently two forms of testosterone injections on the market. Depo-Testosterone is administered every 2–4 weeks, and Aveed is given five times a year.

  • Depo-Testosterone (1 mL of 200 mg/mL, one vial): $38 (generic: $35) (GoodRx, n.d.-h).
  • Aveed (3 mL of 250 mg/mL, one vial): $1,560 (no generic available) (Drugs.com, n.d.).

What is TRT?

Testosterone is a male sex hormone (androgen) present in men and women. It plays a role in development at puberty and has a wide-ranging effect on wellness throughout life.

TRT is a form of hormone replacement therapy. Supplemental testosterone comes in various forms (injections, topical solutions, or implantable pellets) and is used to increase testosterone levels in the body. 

TRT is primarily prescribed to lessen the symptoms of low testosterone in men; women are given TRT less frequently. Some providers also recommend TRT for gender dysphoria treatment.

Low T is common as men get older. A large clinical trial found that 39% of men above 45 have low testosterone (Mulligan, 2006). Testosterone levels fall about 1–2% a year, starting around age 40 (Miah, 2019). 

Symptoms of low testosterone

In men, signs of low T can include (Sizar, 2021): 

For women, symptoms of low testosterone include (Scavello, 2019):

  • Low sex drive
  • Low sexual sensitivity
  • Decreased sexual arousal and ability to orgasm
  • Fatigue

A healthcare provider can check your testosterone levels with a simple blood test. The normal range for testosterone in men is between 300–1000 ng/dL. The American Urological Association defines low testosterone as a total testosterone level below 300 ng/dL (Mulhall, 2018). In women, the regular range is 15–46 ng/dL (Braunstein, 2011). 

 Is TRT right for me?

If you have symptoms of low T, seek medical advice. A healthcare provider can detail the benefits of testosterone replacement therapy, any potential risks, and work with you to formulate a treatment plan. 

The U.S. Food and Drug Administration (FDA) includes a warning about the potential risk of heart attacks and strokes in some people using TRT (FDA, 2018). Testosterone treatment can also have side effects like infertility. It may not be right for you if you have certain medical conditions, such as prostate cancer

As you can see, one factor to consider with TRT is cost, which ranges widely depending on the type. Different insurance companies have their own policies regarding coverage for TRT. Your insurance provider can tell you how much you can expect to pay out of pocket for TRT. 

References

  1. Bassil, N., Alkaade, S., & Morley, J. E. (2009). The benefits and risks of testosterone replacement therapy: a review. Therapeutics and Clinical Risk Management, 5(3), 427–448. doi:10.2147/tcrm.s3025. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701485/
  2. Braunstein, G. D., Reitz, R. E., Buch, A., et al. (2011). Testosterone reference ranges in normally cycling healthy premenopausal women. The Journal of Sexual Medicine, 8(10), 2924–2934. doi:10.1111/j.1743-6109.2011.02380.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21771278/.
  3. Drugs.com. (n.d.). Aveed prices, coupon & patient assistance programs. Retrieved from https://www.drugs.com/price-guide/aveed.
  4. GoodRx. (n.d.-a). Androderm prices, coupons & savings tips. Retrieved from https://www.goodrx.com/androderm
  5. GoodRx. (n.d.-b). Androgel prices, coupons & savings tips. Retrieved from https://www.goodrx.com/androgel
  6. GoodRx. (n.d.-c). Testim prices, coupons & savings tips. Retrieved from https://www.goodrx.com/testim
  7. GoodRx. (n.d.-d). Fortesta prices, coupons & savings tips. Retrieved from https://www.goodrx.com/fortesta
  8. GoodRx. (n.d.-e). Vogelxo prices, coupons & savings tips. Retrieved from https://www.goodrx.com/vogelxo
  9. GoodRx. (n.d.-f). Axiron prices, coupons & savings tips. Retrieved from https://www.goodrx.com/axiron
  10. GoodRx. (n.d.-g). Natesto prices, coupons & savings tips. Retrieved from https://www.goodrx.com/natesto
  11. GoodRx. (n.d.-h). Depo-Testosterone prices, coupons & savings tips. Retrieved from https://www.goodrx.com/depo-testosterone
  12. Mazer, N. A. (2002). Testosterone deficiency in women: etiologies, diagnosis, and emerging treatments. International Journal of Fertility and Women’s Medicine, 47(2), 77–86. Retrieved from https://www.researchgate.net/publication/11379745_Testosterone_deficiency_in_women_Etiologies_diagnosis_and_emerging_treatments
  13. Miah, S., Tharakan, T., Gallagher, K. A., et al. (2019). The effects of testosterone replacement therapy on the prostate: a clinical perspective. F1000Research, 8, F1000 Faculty Rev-217. doi:10.12688/f1000research.16497.1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392157/
  14. Mulhall, J. P., Trost, L. W., Brannigan, R. E., et al. (2018) Evaluation and management of testosterone deficiency: AUA guideline. Journal of Urology, 200, 423. Retrieved from https://www.auanet.org/guidelines/testosterone-deficiency-guideline
  15. Mulligan, T., Frick, M. F., Zuraw, Q. C., et al. (2006). Prevalence of hypogonadism in males aged at least 45 years: the HIM study. International Journal of Clinical Practice, 60(7), 762–769. doi:10.1111/j.1742-1241.2006.00992.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16846397/
  16. Scavello, I., Maseroli, E., Di Stasi, V., & Vignozzi, L. (2019). Sexual health in menopause. Medicina, 55(9), 559. doi:10.3390/medicina55090559. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31480774/
  17. Sizar, O. & Schwartz, J. (2021). Hypogonadism. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532933/
  18. Tsametis, C. P. & Isidori, A. M. (2018). Testosterone replacement therapy: For whom, when and how? Metabolism, 86, 69-78. doi:10.1016/j.metabol.2018.03.007. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29530796/
  19. Tyagi, V., Scordo, M., Yoon, R. S., et al. (2017). Revisiting the role of testosterone: are we missing something? Reviews in Urology, 19(1): 16–24. doi:10.3909/riu0716. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434832/
  20. U. S. Food and Drug Administration (FDA). (2018). FDA Drug Safety Communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due