Imperial College London
Alternate

ProfessorWaljitDhillo

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology & Metabolism
 
 
 
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Contact

 

+44 (0)20 7594 3487w.dhillo Website

 
 
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Assistant

 

Ms Suzanne Wheeler +44 (0)20 7594 3487

 
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Location

 

6N6ECommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hernández:2024:10.1111/andr.13597,
author = {Hernández, R and de, Silva NL and Hudson, J and Cruickshank, M and Quinton, R and Manson, P and Dhillo, WS and Bhattacharya, S and Brazzelli, M and Jayasena, CN},
doi = {10.1111/andr.13597},
journal = {Andrology},
pages = {477--486},
title = {Cost-effectiveness of testosterone treatment utilising individual patient data from randomised controlled trials in men with low testosterone levels.},
url = {http://dx.doi.org/10.1111/andr.13597},
volume = {12},
year = {2024}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Testosterone is safe and highly effective in men with organic hypogonadism, but worldwide testosterone prescribing has recently shifted towards middle-aged and older men, mostly with low testosterone related to age, diabetes and obesity, for whom there is less established evidence of clinical safety and benefit. The value of testosterone treatment in middle-aged and older men with low testosterone is yet to be determined. We therefore evaluated the cost-effectiveness of testosterone treatment in such men with low testosterone compared with no treatment. METHODS: A cost-utility analysis comparing testosterone with no treatment was conducted following best practices in decision modelling. A cohort Markov model incorporating relevant care pathways for individuals with hypogonadism was developed for a 10-year-time horizon. Clinical outcomes were obtained from an individual patient meta-analysis of placebo-controlled, double-blind randomised studies. Three starting age categories were defined: 40, 60 and 75 years. Cost utility (quality-adjusted life years) accrued and costs of testosterone treatment, monitoring and cardiovascular complications were compared to estimate incremental cost-effectiveness ratios and cost-effectiveness acceptability curves for selected scenarios. RESULTS: Ten-year excess treatment costs for testosterone compared with non-treatment ranged between £2306 and £3269 per patient. Quality-adjusted life years results depended on the instruments used to measure health utilities. Using Beck depression index-derived quality-adjusted life years data, testosterone was cost-effective (incremental cost-effectiveness ratio <£20,000) for men aged <75 years, regardless of morbidity and mortality sensitivity analyses. Testosterone was not cost-effective in men aged >75 years in models assuming increased morbidity and/or mortality. CONCLUSIONS AND FUTURE RESEARCH: Our data suggest that testosterone is cost-effective in men &l
AU  - Hernández,R
AU  - de,Silva NL
AU  - Hudson,J
AU  - Cruickshank,M
AU  - Quinton,R
AU  - Manson,P
AU  - Dhillo,WS
AU  - Bhattacharya,S
AU  - Brazzelli,M
AU  - Jayasena,CN
DO  - 10.1111/andr.13597
EP  - 486
PY  - 2024///
SP  - 477
TI  - Cost-effectiveness of testosterone treatment utilising individual patient data from randomised controlled trials in men with low testosterone levels.
T2  - Andrology
UR  - http://dx.doi.org/10.1111/andr.13597
UR  - https://www.ncbi.nlm.nih.gov/pubmed/38233215
VL  - 12
ER  -
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