(078) The Release of the AUA Testosterone Guidelines Correlate With an Increase in Testosterone Prescriptions Among Urologists

Abstract

Abstract Introduction There has been a continued increase in total testosterone prescriptions since 2014. The AUA published guidelines regarding the evaluation and treatment of men with testosterone deficiency in 2018. There is a paucity of literature addressing the prescription trends of different specialties during the release of the 2018 Guidelines. Objective We aimed to elucidate the testosterone prescription trends overall and of each specialty from 2016 to 2019 as the 2018 AUA testosterone guidelines were released. Methods Publicly available data from the Center for Medicare Services (CMS) Part D Prescriber database with regards to testosterone prescriptions across a 4-year span (January 1, 2016-December 31, 2019) were analyzed. Prescribers were categorized into specialties based on their NPI. We analyzed the trends of specialties with over 100 prescribers and prescribers overall using a negative binomial model. Results Family practice, internal medicine, urology, endocrinology, nurse practitioners (NPs), physician assistants (PAs), general practice, infectious disease, and emergency medicine (listed in order of descending testosterone prescribers) were the nine specialties with over 100 testosterone prescribers. From 2016 to 2019 each specialty had an increase in the number of prescribers except for emergency medicine which had a 4% decline (Figure 1). Nurse practitioners had the largest relative increase at 118%. The average number of claims increased each year from 2016 to 2019. However, focusing on consecutive years only 2017 and 2018 significantly differ (p=0.015) with urologists having the largest increase in average yearly claims (40 to 43 claims) (Figure 2). NPs and PAs both have an increasing share of the total testosterone claims from 2016 to 2019 (Figure 3). Conclusions The number of prescribers and claims for testosterone continued to increase from 2016 to 2019 based on CMS data. Our analysis showed that only 2017 to 2018 had a statistically significant increase in average claims corresponding to the year the AUA guidelines were released. Urologists on average prescribe the most testosterone and had the highest increase in claims per provider in 2018. Additionally, NPs and PAs are prescribing an increasing share of testosterone over the course of our analysis. Disclosure No