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The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility

BACKGROUND: Recent changes to the Biologics Price Competition and Innovation Act of 2009 have created barriers to accessing therapy for men utilizing gonadotropins for hypogonadism and infertility. AIM: In this study we sought to investigate ways to decrease disparities in the treatment of male hypo...

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Autores principales: Borgert, Benjamin J, Bacchus, Michael W, Hernandez, Alexandra D, Potts, Shelby N, Campbell, Kevin J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083688/
https://www.ncbi.nlm.nih.gov/pubmed/37051549
http://dx.doi.org/10.1093/sexmed/qfad004
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author Borgert, Benjamin J
Bacchus, Michael W
Hernandez, Alexandra D
Potts, Shelby N
Campbell, Kevin J
author_facet Borgert, Benjamin J
Bacchus, Michael W
Hernandez, Alexandra D
Potts, Shelby N
Campbell, Kevin J
author_sort Borgert, Benjamin J
collection PubMed
description BACKGROUND: Recent changes to the Biologics Price Competition and Innovation Act of 2009 have created barriers to accessing therapy for men utilizing gonadotropins for hypogonadism and infertility. AIM: In this study we sought to investigate ways to decrease disparities in the treatment of male hypogonadism by increasing access to gonadotropin therapy by identifying 503b outsourcing pharmacies which currently provide gonadotropin therapy. METHODS: A review of 503b compounding pharmacies was performed using the online published registry available from the US Food and Drug Administration (FDA). Each pharmacy was contacted regarding their ability to provide gonadotropin therapy. Pharmacies were also queried regarding the impact of FDA-related legal changes and cost considerations. OUTCOMES: The study outcomes were the number and location of FDA-approved 503b compounding pharmacies supplying human chorionic gonadotrophin (hCG) and/or follicle-stimulating hormone (FSH) for the treatment of male hypogonadism and infertility. RESULTS: The 81 503b-compounding pharmacies approved by the FDA to produce hCG and FSH therapy were identified using the FDA registry. Seventy-five of the 81 pharmacies responded to the survey (response rate 92.6%). Of the contacted pharmacies, 5 provided hCG (6.67%). Of the pharmacies offering compounded hCG, 4 offered FSH. No additional pharmacies offered compounded FSH. Eight pharmacies had previously provided hCG and FSH. Six of the 8 pharmacies that stopped making hCG and FSH cited the 2020 FDA mandate as the reason for halting compounding services. Of the 75 pharmacies that responded, only 1 pharmacy provided the cost for FSH ($287 per 100-IU vial), and 3 pharmacies provided the cost for hCG ($50-$83 per 10 000-IU vial). CLINICAL IMPLICATIONS: There are few FDA-approved outsourcing pharmacies currently providing male gonadotropin therapy, and increasing awareness of these pharmacies may decrease barriers to care for patients with male hypogonadism and infertility. STRENGTHS AND LIMITATIONS: The strengths of this article are the clinical utility of the data presented, as this article may serve as a tool for clinicians to increase patient access to therapy. All FDA-approved 503b outsourcing pharmacies were contacted, and 92.6% participated in this project. Limitations of this article were the following: no non-FDA–approved compounding pharmacies such as 503a pharmacies were contacted, participant-reported outcomes were utilized, and only 3 contacted outsourcing pharmacies provided a cost for FSH or hCG, allowing for an unknown degree of cost variability between outsourcing pharmacies. CONCLUSIONS: There currently exists limited access to FDA-approved compounded gonadotropin therapies for hypogonadism and male infertility, and these results demonstrate the barriers to hCG and FSH access and the need for additional treatment options for this vulnerable patient population.
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spelling pubmed-100836882023-04-11 The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility Borgert, Benjamin J Bacchus, Michael W Hernandez, Alexandra D Potts, Shelby N Campbell, Kevin J Sex Med Pharmacotherapy BACKGROUND: Recent changes to the Biologics Price Competition and Innovation Act of 2009 have created barriers to accessing therapy for men utilizing gonadotropins for hypogonadism and infertility. AIM: In this study we sought to investigate ways to decrease disparities in the treatment of male hypogonadism by increasing access to gonadotropin therapy by identifying 503b outsourcing pharmacies which currently provide gonadotropin therapy. METHODS: A review of 503b compounding pharmacies was performed using the online published registry available from the US Food and Drug Administration (FDA). Each pharmacy was contacted regarding their ability to provide gonadotropin therapy. Pharmacies were also queried regarding the impact of FDA-related legal changes and cost considerations. OUTCOMES: The study outcomes were the number and location of FDA-approved 503b compounding pharmacies supplying human chorionic gonadotrophin (hCG) and/or follicle-stimulating hormone (FSH) for the treatment of male hypogonadism and infertility. RESULTS: The 81 503b-compounding pharmacies approved by the FDA to produce hCG and FSH therapy were identified using the FDA registry. Seventy-five of the 81 pharmacies responded to the survey (response rate 92.6%). Of the contacted pharmacies, 5 provided hCG (6.67%). Of the pharmacies offering compounded hCG, 4 offered FSH. No additional pharmacies offered compounded FSH. Eight pharmacies had previously provided hCG and FSH. Six of the 8 pharmacies that stopped making hCG and FSH cited the 2020 FDA mandate as the reason for halting compounding services. Of the 75 pharmacies that responded, only 1 pharmacy provided the cost for FSH ($287 per 100-IU vial), and 3 pharmacies provided the cost for hCG ($50-$83 per 10 000-IU vial). CLINICAL IMPLICATIONS: There are few FDA-approved outsourcing pharmacies currently providing male gonadotropin therapy, and increasing awareness of these pharmacies may decrease barriers to care for patients with male hypogonadism and infertility. STRENGTHS AND LIMITATIONS: The strengths of this article are the clinical utility of the data presented, as this article may serve as a tool for clinicians to increase patient access to therapy. All FDA-approved 503b outsourcing pharmacies were contacted, and 92.6% participated in this project. Limitations of this article were the following: no non-FDA–approved compounding pharmacies such as 503a pharmacies were contacted, participant-reported outcomes were utilized, and only 3 contacted outsourcing pharmacies provided a cost for FSH or hCG, allowing for an unknown degree of cost variability between outsourcing pharmacies. CONCLUSIONS: There currently exists limited access to FDA-approved compounded gonadotropin therapies for hypogonadism and male infertility, and these results demonstrate the barriers to hCG and FSH access and the need for additional treatment options for this vulnerable patient population. Oxford University Press 2023-04-10 /pmc/articles/PMC10083688/ /pubmed/37051549 http://dx.doi.org/10.1093/sexmed/qfad004 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Pharmacotherapy
Borgert, Benjamin J
Bacchus, Michael W
Hernandez, Alexandra D
Potts, Shelby N
Campbell, Kevin J
The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title_full The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title_fullStr The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title_full_unstemmed The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title_short The availability of gonadotropin therapy from FDA-approved pharmacies for men with hypogonadism and infertility
title_sort availability of gonadotropin therapy from fda-approved pharmacies for men with hypogonadism and infertility
topic Pharmacotherapy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10083688/
https://www.ncbi.nlm.nih.gov/pubmed/37051549
http://dx.doi.org/10.1093/sexmed/qfad004
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