Testosterone is a hormone produced by the sex organs: testicles in males and ovaries in females. Both males and females produce testosterone, although testosterone levels (T levels) are higher in people assigned male at birth than in people assigned female at birth. Healthcare providers generally prescribe testosterone replacement therapy (TRT) to individuals with low testosterone, primarily using it to treat hypogonadism, the medical term for low testosterone in men.
“Testosterone can be used as part of gender-affirming hormone therapy to induce virilization (development of male secondary sexual characteristics) and suppress menstruation in people assigned female at birth or to promote feminization in people assigned male at birth,” says David Shusterman, MD, chief physician and founder of NY Urology in New York.
However, the cost of testosterone can vary based on factors like dosage and the type of TRT needed. Always ask your doctor for medical advice and check your insurance plan for specific policy information.
How much does testosterone cost?
The cost of synthetic testosterone is, on average, between $100 and $450 per month but depends on various factors, whether it’s brand name or generic, whether you have insurance that covers it for a medical reason, and the form of testosterone.
“Injectable forms dominate the market due to their proven efficacy and ease of administration,” Dr. Shusterman says.
On the other hand, oral testosterone is the least commonly prescribed form. “It takes larger amounts, and the bioavailability is unreliable because the testosterone is metabolized by the [liver and] gut,” says Iginio (Gino) Stoppa, ND, a naturopathic physician at Sonoran University.
Testosterone injections cost
Testosterone cypionate is the generic version of the brand-name prescription medication Depo-Testosterone. Both are intramuscular injections. The cost for two vials without insurance is around $105, which is how much you would pay per month if your healthcare provider prescribed one injection every two weeks. Cost also varies by dosage.
“Intramuscular injection tends to be the most reliable form of delivery and absorption, has the fewest side effects, and is the most affordable,” Dr. Stoppa says.
The average injection dosage can vary between 50 milligrams (mg) and 400 mg every two to four weeks for patients with low T. Individuals can expect to pay about $1,200 per year for injectable testosterone cypionate.
Testosterone pellets cost
Testosterone pellets are inserted under the skin, continuously releasing the hormone for up to six months, and the starting dosage varies based on the patient’s needs.
“Before determining the appropriate pellet dosage, you’ll undergo comprehensive blood tests and a thorough evaluation by a qualified healthcare provider specialized in hormone therapy,” Dr. Shusterman says. “These tests help assess your current hormone levels and identify any deficiencies or imbalances.”
The average cost is around $1,200 for 10 (75 mg) Testopel pellets without insurance. The dosage may affect the price.
Testosterone pills cost
Oral testosterone capsules cost between $1,000–$2,000 monthly without insurance. Cost may vary based on dosage, baseline testosterone levels, and the reason for taking them.
Each bottle of Jatenzo contains 60 capsules (237 mg) and is around $1,200 before insurance. According to Mayo Clinic, the typical beginning dose is one pill taken twice daily—once in the morning and once at night.
Tlando testosterone pills come in bottles of 120 (112.5 mg) capsules. Each bottle is around $900 before insurance. According to Mayo Clinic, the suggested dose is two 225 mg capsules twice daily: one in the morning and one at night.
Cost of testosterone gel and cream
Testosterone therapy can also come in topical gels and creams. “This allows for absorption through the skin and gradual increase of testosterone levels to reach the desired range,” Dr. Shusterman says.
On average, gel and cream testosterone cost between $400 and $1,000 monthly. The dosage and brand may affect the cost.
Brand-name Natesto nasal gel costs about $360 per tube. Each tube lasts for 60 uses or 10 days, making the monthly cost about $1,000 without insurance. The recommended daily dose of Natesto is 33 mg between two pumps per nostril, three times daily.
Androgel topical testosterone (1.62%) comes in two forms: a solution applied to the underarms and a gel applied to the shoulders, upper arms, or thighs. The recommended starting dosage is either two pumps (40.5 mg) or one packet daily each morning.
Dosage will depend on the person’s current testosterone levels. According to the drug label, each bottle of Androgel contains 60 metered doses. On average, a bottle of Androgel costs around $800, so about $400 monthly.
Cost of testosterone patches
Extended-release patches allow for transdermal administration of testosterone. The monthly cost of Androderm patches is about $800 without insurance. This cost can vary depending on dosage, medication strength, and how long someone uses the medication.
According to Mayo Clinic, doctors typically prescribe a treatment plan of one patch (4 mg) for 24 hours before replacing it. Each box of 24-hour Androderm patches contains 30 doses.
You can get coupons for Androderm testosterone patches and pay around $500 with the SingleCare prescription card.
Testosterone buccal systems (gum and cheek)
Striant is an oral patch testosterone product applied to the upper gums. These tablet-looking patches cost around $180 per month. Typically, adults will take a starting dose of 30 mg twice daily, but this can vary.
“Your healthcare provider will consider various factors like your age, overall health, and hormone levels before determining the right dosage for you. They may even adjust it over time based on how well you respond to treatment,” Dr. Shusterman says.
Does insurance cover testosterone?
Most insurance policies cover testosterone as long as treatment is deemed medically necessary. “Many insurance companies will not cover it for low testosterone secondary to older age,” Dr. Stoppa says.
With health insurance savings, testosterone prices can drop dramatically, but this varies by insurance provider and policy.
There are specific criteria patients must meet to qualify for coverage. “These requirements might include obtaining a diagnosis of hypogonadism or low testosterone levels through blood tests, demonstrating symptoms such as fatigue, decreased libido, or muscle loss, and potentially consulting with an endocrinologist or urologist prior to receiving treatment,” Dr. Shusterman says.
“Many insurance companies will require two abnormally low testosterone labs based on current practice guidelines,” Dr. Stoppa says.
Do Medicare and Medicaid cover testosterone?
Since testosterone replacement therapy is a lifelong treatment, looking into subsidized health insurance can be a smart choice for some people. Typically, Medicare and Medicaid cover TRT as long as the patient meets their state’s criteria for coverage.
“The process may differ slightly between the two programs,” Dr. Shusterman says. “Medicare covers testosterone replacement therapy (TRT) if medically necessary, typically when hormone levels fall below a certain threshold. However, prior authorization and documentation of medical necessity from a healthcare provider are required.”
As for Medicaid coverage, guidelines vary by state.“Most states offer some level of coverage for TRT under their prescription drug benefit,” Dr. Shusterman says. Patients should always consult their healthcare provider for professional medical advice and ensure they know about available coverage and policy details.
Bottom line
On average, someone can expect to spend between $100 and $450 per month on testosterone replacement therapy, depending on what kind, how much they need, and their health insurance coverage.
People should review their insurance policy and make note of coverage requirements and limitations. Typically, brand-name medications will cost more than generic medications.
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Sources
- Testosterone, Cleveland Clinic (2022)
- Male hypogonadism: Symptoms and treatment, Journal of Advanced Pharmaceutical Technology & Research (2010)
- Testosterone (oral route), Mayo Clinic (2023)
- How to use, Natesto (2023)
- Dosing & titration, Androgel (2022)
- Androgel testosterone gel prescribing information, NIH National Library of Medicine
- Testosterone (transdermal route), Mayo Clinic (2023)