PBS changes to testosterone treatment
In April this year, the PBS made changes to who can receive PBS for testosterone treatment. These changes are due to uncertainty about the significance of low testosterone in older men and concerns about over-prescription in this setting.
Prior to these changes, testosterone could be prescribed by GPs however now prescriptions for testosterone therapy require validation by an endocrinologist, urologist or member of the Australasian Chapter of Sexual Health Medicine. This means that a patient will need to see one of these specialists and the specialist needs to agree that this treatment is necessary and meets one of the indications, before subsidised treatment can continue.
Although these changes are necessary to ensure that public funds are used in the most effective manner, it has unfortunate consequences for men who are wishing to receive treatment including a delay in treatment, extra appointments and associated time off work as well as travelling and parking fees. Fortunately, at the Keogh Institute our male health clinic and endocrinology clinic operate on the same grounds allowing the process to be completed more quickly, possibly even on the same day.
Who is eligible?
Under the new changes the following groups of men remain eligible for subsidised testosterone treatment under consultation with a specialist.
- Androgen deficiency due to a pituitary or testicular disease
- Micropenis
- Constitutional delay of growth or puberty
- When induction of puberty is required
However men who are over 40 and androgen deficient without a pituitary or testicular disease, have had a change in the criteria for eligibility with the level of testosterone in the blood considered to be deficient being lowered from 8nmol per litre to 6 nmol per litre.
If you think this might affect you, you should contact your doctor or our men’s health clinic for further advice.
Further information about the changes can be found at Andrology Australia.
The future for testosterone treatment
These guidelines are likely to change in the future as new evidence emerges about the significance of isolated lower testosterone in older men. We remain devoted to research into this area, such as through the T4DM study which is examining whether testosterone treatment reduces the risk of diabetes.