Men without pathological hypogonadism are still being prescribed testosterone despite a PBS crackdown, likely because many are now androgen dependent, a study suggests.

PBS prescribing criteria for initiating testosterone treatment were tightened in 2015 to exclude androgen deficiency due to age, obesity or CVD, and to require consultation with a non-GP specialist.

At that time, more than 80% of new scripts were for men older than 40 and more than 70% of all new scripts were for low testosterone, without pathology, despite a lack of evidence for efficacy and concern about cardiovascular adverse events.

A study by andrologist Professor David Handelsman, director of the ANZAC Research Institute at the University of Sydney, has examined what happened in the ensuing three years, based on PBS data and drug sales figures purchased from industry data company IQVIA.