The barrage of advertisements targets older men. “Have you noticed a recent deterioration of your ability to play sports?” “Do you have a decrease in sex drive?” “Do you have a lack of energy?”
If so, the ads warn, you should “talk to your doctor about whether you have low testosterone” – “Low T,” as they put it.
In the view of many physicians, that is in large part an invented condition. Last year, drugmakers in the United States spent $3.47 billion on advertising directly to consumers, according to FiercePharma.com. And while ever-present ads such as those from AbbVie Pharmaceuticals have buoyed sales of testosterone gels, that may be bad for patients as well as the United States’ $2.7 trillion annual health-care bill, experts say.
Sales of prescription testosterone gels that are absorbed through the skin generated more than $2 billion in U.S. sales last year, a number that is expected to more than double by 2017. Abbott Laboratories – which owned AbbVie until Jan. 1 – spent $80 million advertising its version, AndroGel, last year.
Once a niche treatment for people suffering from hormonal deficiencies caused by medical problems such as endocrine tumors or the disruptive effects of chemotherapy, the prescription gels are increasingly being sold as lifestyle products, to raise dipping levels of the male sex hormone as men age.
“The market for testosterone gels evolved because there is an appetite among men and because there is advertising,” said Dr. Joel Finkelstein, an associate professor at Harvard Medical School who is studying male hormone changes with aging. “The problem is that no one has proved that it works, and we don’t know the risks.”
Dr. Eric Topol, a cardiologist and chief academic officer at Scripps Health in San Diego, is alarmed by the high percentage of patients he sees who use the roll-on prescription products, achieving testosterone levels that he described as “ridiculously high.”
The FDA has approved the gels “for use in men who either no longer produce the male sex hormone testosterone or produce it in very low amounts.” But that directive is ambiguous, and the FDA office did not respond to questions because of the government shutdown.
Drug companies defend their efforts to reach out to potential users. Testosterone deficiency is “a recognized clinical condition, with signs/symptoms that can impact millions of patients,” said Morry B. Smulevitz, a director of communications for Lilly, which makes Axiron.
