Hormones 101

How Much Can Testosterone Replacement Therapy Cost?

by Mike McAvennie11/12/2021

Testosterone

Know how important it is to keep your T levels balanced, as well as the potential costs associated with doing so.

Men experience a natural decline in their testosterone levels as they age — as much as 1.5% per year on average. The testes synthesize less testosterone, which tells the hypothalamus to lower its production of gonadotropin-releasing hormone (GnRH). This action discourages your pituitary gland from producing Luteinizing hormone (LH), which ultimately results in lower total testosterone production.

Test-decrease-by-age

However, many men’s levels can fall far below what the American Urological Association (AUA) [1] guidelines categorize as normal. When that happens, they’re most likely experiencing clinically significant testosterone deficiency — specifically, hypogonadism or Low T.

If you’re diagnosed with low testosterone, your doctor may recommend and prescribe TRT, which is an acronym for testosterone replacement therapy. Through one of several methods we’ll delve into here, TRT replenishes your body with testosterone to combat the conditions that are often attributable to Low T.

TRT has helped thousands of men, though millions more remain hesitant about seeking treatment. There are a variety of reasons as to why: concern over how others may view them, stigmas based on conflicting or outdated information, or a fear of certain methods of treatment, such as self-injection.

Another reason why men are apprehensive about TRT is its potential cost. It’s certainly understandable — money doesn’t go as far as it used to, and a look at the multiple firms that offer TRT can indicate that it’s very costly. Yet, the costs associated with TRT can vary, and if you do your due diligence, they may not be as expensive as you think.

Why You’d Need TRT


Having low testosterone may adversely impact normal functions throughout the body, which could increase your risk of other health issues. Low T symptoms and their respective severity can fluctuate within each individual due to their age and any preexisting conditions, and may include:

  • Decreasing muscle, stamina, strength and energy

  • Loss of libido; decreased desire for sex or intimacy

  • Diminished sperm volume

  • Weight gain, body fat redistribution (usually around the midsection or breast tissues)

  • Moodiness; feelings of sadness and irritability

  • Unable to focus and think clearly aka “brain fog”

  • Some hair loss, or less growth in body and facial hair

  • Constantly exhausted but unable to get proper sleep

  • Reduced ability in playing sports, exercising

  • Increasing withdrawal from family, hobbies, going out

    Testosterone-in-the-body

There are also several potentially severe indicators that are linked to low testosterone:

  • Cardiovascular disease, including heart disease and stroke

  • Erectile dysfunction (ED)

  • Respiratory disease

  • Depression

  • Diabetes

  • Osteoporosis (extremely brittle bones), making you more prone to injury

After testing and review, your health provider may prescribe testosterone replacement therapy to rebalance your hormone levels and help reduce or eliminate any combination of the above symptoms. If you’re unsure about whether or not you have Low T, you can also order Hone’s at-home hormone assessment, the cost of which includes an online consultation with a licensed, Hone-affiliated physician.


How Much Does TRT Cost?


Testosterone replacement therapy is effective, and the costs associated with it depends on a number of factors:

  • Your type of treatment/medication and the materials necessary to administer

  • Whether there’s a generic, more affordable version of the medication

  • Your dosage — some of us may require a greater quantity of  treatment than others, meaning they’re also likely to pay more for it

  • How severe your symptoms are

  • How long you may require treatment

  • Your location — the cost of living varies throughout the United States

  • Your pharmacy — there may be additional costs associated with your prescription

  • Insurance plans

The best way to break down the costs is to list what treatment generally entails.

Blood and Lab Work

Assessing your hormones can be pricey, especially since the ensuing treatment is tailored to address specific hormonal deficiencies. In addition to the aforementioned cost factors, there’s also whether or not you’re having your assessment done inside a lab or doctor’s office, or if you’re collecting your own sample and mailing it to a lab.

The expense involved can be wide ranging. A full, 8-hormone panel can cost as much as $800; some labs quote as much as $1,500 for a comprehensive range of tests that aren’t covered by insurance.

Performing at-home testing is a considerably more affordable option. However, it can still be expensive, running anywhere from $80 to $350.

Hone offers an at-home hormone assessment that currently costs $45, and it includes all of the materials necessary for you to collect a blood sample. Once you have done so, you will package and mail your collection to a lab that partners with Hone and is accredited by the Clinical Laboratory Improvement Amendments (CLIA) and, where applicable, by the College of American Pathologists (CAP). A lab’s accreditation means that it meets or exceeds all federal testing standards managed by the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS) and U.S. Food and Drug Administration (FDA).

Medical Services

Once the lab comes back with your results, you’ll schedule an appointment and have a video consultation with a physician that’s affiliated with Hone. (As we mentioned earlier, the cost of this appointment is included with the $45 at-home hormone assessment.) These doctors specialize in endocrinology, urology, internal medicine and hormone replacement therapy. They will review all results with you and determine if you’re a viable candidate for TRT.

Should you qualify, the physician will next outline a pharmaceutical treatment plan that’s tailored specifically for you. They’ll also explain what you should know before proceeding, including the benefits and potential risks associated with TRT.

If you choose to undergo TRT through Hone, you’ll enroll in a subscription plan that costs $120/month, plus the cost of medication, which we’ll cover momentarily. The subscription plan includes:

  • Concierge physician visit

  • Audio/video physician access

  • Private Hone community access

  • Hormone reassessment every 90 days, to determine progress of testosterone levels and whether adjustment of medication/dosage is necessary

  • Free at-home monthly delivery of TRT medications and materials necessary for self-administering

It’s worth pointing out that the costs related to these services, much like those with blood and lab work, can range quite extensively. Depending on factors like medication and dosage, location and insurance eligibility, you can pay as much as $1,000/month for a customized treatment plan. Regardless of whether you choose Hone for your hormone optimization needs, do your research before settling on one firm.

Medication costs (per month)

Let’s say the doctor has determined that your deficient testosterone levels qualify you for TRT. How much will your prescription cost every month?

The same factors that determine the costs of lab/blood work and medical services also pertain to your out-of-pocket expenses for medication. If your doctor administers the treatment, chances are your costs will increase to cover office visits. If you subscribe to an at-home treatment plan, be aware that not all of them will factor in the cost of supplies (e.g., syringes or needles), so be sure to ask before you agree to the treatment.

Let’s have a look at the potential monthly cost of TRT medications:

  • Injections: Injections are generally your most affordable TRT option. Without insurance, the cost of a single 200 mg/mL testosterone vial can range between $40 and $100 a month. (Again, that doesn’t necessarily factor in delivery or the materials required for self-injecting, and the cost increases if the monthly dosage prescribed is higher.)

    Testosterone Injection Vial

    Through Hone, a dosage of 200 mg/mL testosterone starts at $48/month. The price may change if you require a greater monthly dosage. The cost of your medication includes home delivery and the materials needed for injection.

  • Creams: A transdermal form of TRT you apply to specific regions of your body (usually the scrotal area), testosterone cream can cost as little as $30 a month to as much as $500 a month — possibly even more if you’re using a brand name. When added onto Hone’s prescription plan, a monthly subscription of testosterone cream begins at $48/month, with the price adjusted to accommodate your prescribed dosage.

    Testosterone Cream Dispenser
  • Troches: A popular alternative to self-injection and creams, Hone offers this sublingual form of TRT starting at $48/month. The price is comparable if not better than most at-home testosterone firms offering troches as part of their subscription plans.

    Testosterone Troche
  • Oral Rx’s: Prescribed testosterone tablets can be a very pricey alternative – anywhere from $100 to $300 a month. Hone offers options like clomid, starting at $34/month, and anastrozole ($20/month). It’s worth noting, however, that physicians won’t often recommend long-term ingestion of oral testosterone, since there’s a potential concern that they can adversely impact your liver. Discuss with your doctor to decide whether or not this is the best course of treatment for you.


Is Testosterone Replacement Therapy Covered by Insurance?


You’ll read or hear many testosterone firms explain that TRT is covered by insurance, but beware – the insurances that cover such services are few and far between, and you may find that how much they cover doesn’t really add up to all that much.

For full transparency, Hone at this time does not accept insurance. However, our pricing of treatment plans and medication are more than reasonable and comparable to the co-pays offered by most insurances. Furthermore, we accept Health Savings Account (HSA) and Flexible Spending Account (FSA) cards, a pre-taxed advantage that could keep your out-of-pocket expenses minimal.


What is the Best Form of Testosterone Replacement Therapy?


With more options available to you than ever before, deciding which method of TRT is best for you is a tough question, and one that doesn’t necessarily have a wrong answer. Whether you choose subcutaneous injection, cream, troche or oral tables, each method of treatment offers advantages and downsides. (Dr. Danielle McDevitt, a noted physician affiliated with Hone, even weighs in on each of them and offers up her personal preference.)

Ultimately, it’s up to your doctor and you to determine what form of treatment you’ll best respond to, which one can offer the greatest benefits and which might have side effects that may not agree with your body. When discussing with your physician, ask as many questions as possible so you can get a clearer picture and make an informed choice.


Why You Shouldn't Get Your TRT Illegally


Unfortunately, despite radical advancements in recent years, testosterone replacement therapy continues to have a stigma attached to it. Because of the way it’s negatively perceived by detractors, many men feel uncomfortable about considering treatment. Worse, it may also encourage them to pursue purchasing TRT illegally, especially if they’re looking to save money or work around the system because they don’t meet the criteria that categorizes them as being clinically testosterone deficient. Other non-medical reasons may include:

  • Bulking up muscle for bodybuilding or other athletic endeavors

  • Improving sex drive/performance, despite not having a sexual disorder

  • Losing weight

  • Boosting energy and stamina

  • Replacing testosterone that naturally declines in the body due to aging

The reasons why you shouldn’t purchase TRT illegally may seem obvious, but they bear spelling out here. For one thing, you have no idea what you’re actually buying. Testosterone that’s sold on the black market isn’t subject to any government safety standards. As such, the medication may very well be expired, compromised, mislabeled or counterfeit.

Why risk irreversibly damaging the very thing you’re looking to preserve or improve — in this case, your body? TRT is intended to help improve men’s health and their lives, but it’s prescribed only if your body truly needs it. Your doctor can recommend other alternatives that can help naturally boost your hormone levels, whether it’s supplements or altering your diet and exercise regimen. Using TRT illegally only risks your health, and there’s no health professional to help monitor what it may be doing to you.


TRT Risks and Benefits


Testosterone replacement therapy, even when administered and monitored properly, still comes with its share of possible risks. That’s why we can’t emphasize enough that going on any form of TRT must be approved, prescribed and continuously monitored by a physician. The doctor will ensure that you’re taking the correct treatment and dosage, and adjust accordingly. They’ll also make sure that you aren’t experiencing side effects as a result of your treatment.

Potential risks, though rare, can include:

  • Frequent need to urinate

  • Fluid retention around parts of the body (oedema)

  • Acne or oily skin

  • Headaches

  • Lumps or hardening around injection site

There’s also a small possibility that more severe side effects can occur. If this happens, immediately consult with your physician. These side effects can include:

  • Nausea or vomiting

  • Infertility or decreased sperm count

  • Testicular shrinkage

  • Worsening of obstructive sleep apnea

  • Increase in cholesterol levels

  • Abnormal spike in blood sugar levels, which can increase the risk of developing Type 2 diabetes

  • Yellowing of skin or around the eyes

  • Uncomfortable swelling or enlargement of breast tissue (gynecomastia)

  • Redness, warmth around lower leg area

  • Unusual increase in red blood cell count, which can result in high blood pressure, joint/muscle pain, trouble with eyesight or thrombosis (blood clotting)

Fortunately, the health benefits of undergoing testosterone replacement therapy are far more conclusive, and they can include one or many of the following:

  • Increase muscle size and strength

  • Improve erectile function for males with mild ED onset by Low T

  • Revive or improve sex drive/libido

  • Boost cognitive function, including memory and focus

  • Greater energy and stamina

  • Heighten confidence and mood

  • Increase and maintain bone mass

Just like you’d notify your physician of any side effects, update them of any positive progress you see or feel. It’s important to inform the doctor that you’re feeling better or seeing improvements in various aspects of your wellbeing. This way, they know that the prescribed treatment is properly working, and they can better determine what, if any, adjustment is necessary.

Why is that important? In most cases, TRT is a lifelong commitment. Your body no longer naturally produces the same amount of testosterone it used to, so you need treatment to keep your levels balanced. And it’s not just a set course of treatment and you’re done; be aware that optimizing hormones can require constant balancing, and therefore continuous adjustment of dosage and frequency.


What You Need to Do to Get Started


You now have an idea of the costs associated with TRT, plus the forms of treatment that are available to you through Hone. At this point, all you need to do is take the first step and test your testosterone levels. You can get started here with Hone’s at-home hormone assessment, which gives you all of the necessary materials to collect a sample and mail to the lab. Once your results come in, you can schedule your online video consultation with a Hone-affiliated doctor.

If you qualify for TRT and your doctor recommends a method of treatment that’s too expensive for you, there’s no harm in letting them know. There are likely suitable alternatives they can recommend. Those alternatives may work a little differently or take a little longer for you to see the health benefits, but they won’t break your budget. More importantly, they’ll help you toward rediscovering your best self and a better way of living.


References:

[1] Mulhall JP, Trost LW, Brannigan RE et al: Evaluation and management of testosterone deficiency: AUA guideline. J Urol 2018; 200: 423.

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Hone works with board-certified endocrinologists, urologists, internal medicine and other types of physicians who specialize in helping men address medical issues associated with their hormone levels.

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Our physicians create your personalized medical plan using your blood measurements. They will clearly explain the benefits and possible side-effects of your treatment. The Hone care team will check in along the way to make sure everything is going according to plan. You can reach your physician through our secure portal if you have any questions or concerns at any point.

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