Abstract
ABSTRACT Introduction Online telehealth platforms are becoming increasingly common across several areas of medicine, including those related to men's health conditions. These ventures now offer virtual services for the evaluation of testosterone deficiency and treatment via the online sale of testosterone therapy (TTh). Objective We sought to compare the cost of undergoing virtual evaluation and treatment with TTh via online telehealth platforms, as compared to what may be offered by a board-certified urologist following the American Urologic Association (AUA) guidelines at a tertiary care center. Methods Google was queried to identify platforms that offer an online consultation and prescription service for TTh. Platforms that did not provide transparency of services including details of the initial consultation, laboratory work, type of medication offered, and associated fees on the company website were excluded. Information regarding the type of providers used, services and laboratory work included in the initial consultation, and price for the evaluation and three months of treatment with TTh were gathered. These were compared to the services and prices that a board-certified urologist at a tertiary care center may offer while following the AUA guidelines for the evaluation and management of testosterone deficiency. Costs for services at the tertiary care center were estimated using a single institution's online cost estimator1 for a patient with no insurance, a patient with basic employee insurance, and a patient with Medicare. Results A total of three online platforms met inclusion criteria: Hone, Regenex Health, and TRT Nation. The services provided for the initial evaluation and for follow up of patients on TTh were similar between the online platforms and those suggested by AUA guidelines (Table 1). The cost of the initial consultation including laboratory services were lowest for the patient with Medicare at a tertiary center ($0) and via the online platform, Hone ($45.00) (Table 2). The estimated cost for three months of treatment with TRT including follow up was lowest among the patient with Medicare ($32.79) and the patient with basic employee insurance ($192.58) at the tertiary center (Table 3). The cost of three months of treatment and follow up was highest via the online platform Regenex Health ($1,059.00). Conclusions While online telehealth platforms may offer a cost benefit in the initial consultation and evaluation for TRT for some patients, the cost of ongoing treatment greatly exceeds that which may be obtained at a tertiary care center for patients with basic insurance plans or Medicare. Patients without insurance may encounter a high cost of initial evaluation at a tertiary center, however, ongoing follow up and medication costs for these patients is likely similar between select online platforms and a tertiary center. Disclosure No
Published Version
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