If you have low testosterone (T), then you probably already know that it can lead to debilitating symptoms, such as persistent fatigue, weight gain, muscle loss, erectile dysfunction, depression, and more.
This is why the condition should be managed by an effective and FDA-approved treatment such as TRT (testosterone replacement therapy). TRT is also the most widely-prescribed treatment for low T due to its high effectiveness and safety.
While some patients are concerned about the price of a prescription, the actual monthly cost of TRT can be quite affordable, as it depends on the form, brand, and dosage of the medication.
Some forms of TRT, such as testosterone injections, can have a starting monthly cost as low as $30 but offer great value as TRT is highly effective at managing your symptoms and restoring your quality of life.
Considering that TRT is relatively affordable, it is often purchased illegally by individuals with normal testosterone levels such as bodybuilders who want to improve their strength and body composition.
Despite the low price of the medication, purchasing TRT illegally and using it without medical supervision carries unnecessary risks which can lead to health problems that will cost much more in the long run.
What’s the average cost of TRT?
The cost of TRT depends on several factors, such as the form and the brand of the medication, as well as the dosage you need depending on the severity of your condition. It may also vary depending on which US state you are situated in.
The start of TRT usually involves relatively low doses and the price may be as low as $30 per month for testosterone injections.
Yet, other forms of TRT can cost considerably more, so the average monthly cost of testosterone is between $50 and $1000.
Furthermore, your doctor may eventually increase your dosage or change your form of TRT, which may also affect the monthly cost.
Illegal testosterone medications are usually dramatically cheaper compared to legal and FDA-approved TRT medications. That’s because they are shipped from abroad and do not undergo any quality checks.
However, the lack of control also makes these medications highly dangerous because there is no guarantee of their quality and safety. That’s why if you want to buy legal and safe testosterone online, you first need to get a prescription from your doctor.
How much does testosterone cost with insurance?
FDA-approved forms of TRT are usually covered by insurance as long as you can prove that you have medical indications for receiving the therapy
Medical conditions covered by insurance companies include low testosterone levels due to male hypogonadism or due to long-term therapy with glucocorticoids.
If you meet all requirements, an insurance company can partially cover your expenses and reduce your monthly cost by $30 – $100.
Insurance companies also often have a preferred form and brand of TRT. Therefore, the actual amount of coverage can vary widely depending on the specific medication as well as the dosage you require – anywhere from 10-90% of the total cost.
Testosterone injections cost
TRT injections involve the application of testosterone esters which are compounds that transform into regular testosterone in the human body. Currently, there are 3 different esters approved by the FDA.
These are testosterone cypionate, undecanoate, and enanthate. They are available as brand-name medications and generic medications. It’s important to note that generic medications are usually more affordable than brand products.
In terms of safety, injections can have local side effects, such as redness, pain, and irritation at the injection site.
The monthly cost of testosterone injections varies greatly between brands and different esters, and it can be anywhere in the range of $50 – $1000.
Testosterone cypionate is one of the most affordable forms of TRT, with a starting price of $30 for a 200 mg vial and up to $150 for a 2000 mg vial.
In the US, it is available as a generic medication or the brand name Depo-testosterone manufactured by Pfizer, US. Depo-testosterone was FDA-approved in 1997.
Testosterone cypionate must be applied as intramuscular injections. It is usually dosed 50 to 400 mg and taken every 2-4 weeks. Considering this dosing regime, the monthly cost of testosterone cypionate is around $30 to $60.
Testosterone enanthate is available as both subcutaneous and intramuscular injections. The subcutaneous injections bear the brand name Xyosted and have been FDA-approved since 2018.
They are manufactured by Antares Pharma, US, and cost about $600 for a 200 mg vial. Xyosted is usually taken in doses of 50-100 mg once per week, which means that its monthly cost is about $600 – $1200.
Generic forms of Testosterone enanthate are available as intramuscular injections, which must be applied every 1-4 weeks in doses ranging from 50 to 400 mg. They are considerably cheaper, and a 1000 mg vial costs around $50.
Testosterone undecanoate is another form of TRT which must be injected intramuscularly. The product has a longer half-life which allows for less frequent injections.
It is available as a brand name product Aveed, manufactured by Endo Pharmaceuticals. Aveed was approved by the FDA in 2014. It comes in 750 mg vials and costs around $1700. Unfortunately, there is no generic option.
Considering the fact that 750 mg of testosterone undecanoate should be applied every 10-12 weeks, the monthly cost of the therapy is around $550 – $650.
Testosterone gel cost
Testosterone gels are available under several brand names, including AndroGel, Fortesta, Natesto, Testim, and Vogelxo.
The average monthly price for testosterone gel is in the range of $200-1200. For each of these brands, except Natesto, there is a generic version as well, which is about 3 times less expensive.
Testosterone gels are best suited for patients who want to completely avoid taking injections or other mini-invasive procedures.
Unfortunately, the downside of using testosterone gels is that the absorption is slower, the therapy requires daily application, and the gel can be passed to other people via direct contact.
Furthermore, transdermal application of testosterone may also lead to higher DHT levels compared to other routes of administration.
Testim is a transdermal gel with a concentration of 1%, which costs $20 per 5g tube. Therefore the whole package contains 50 mg of testosterone. The recommended daily dose is 50-100 mg, so two tubes are sufficient for 1-2 days. Thus, the monthly price is about $600-1200.
Vogelxo is a similar transdermal gel that comes in tubes, packages, or a gel pump. Each tube costs about $15. Considering the fact that the recommended daily dose is 50-100 mg of testosterone and you may have to use 1-2 packages/tubes a day, the monthly price of this gel is $450-900.
Natesto is a nasal gel with a concentration of 4.5%, which costs about $200 for 11g. Therefore the whole package contains about 0.5 grams of testosterone. The recommended daily dose is 11-33 mg, so one gel is sufficient for 2-6 weeks. Thus, the monthly price is about $200.
Fortesta is a transdermal gel with a concentration of 5%, which costs about $450 for 60g. Thus, the whole package contains about 3 grams of testosterone. The recommended daily dose is 40-70 mg, so one gel is sufficient for 6-10 weeks. Therefore, the monthly price is about $200-300.
AndroGel is a transdermal gel with a concentration of 1% or 1.62%, which costs about $650 for 75g of gel pump. Therefore the whole package contains about 7-12 grams of testosterone. The recommended daily dose is 40-100 mg, so one gel is sufficient for 2-3 months. Thus, the monthly price is about $200-300.
Testosterone pellets and patches cost
Similarly to testosterone gels, patches are also suitable for patients who want to avoid invasive procedures. The patches also require a daily application, but there is a lower risk that you may pass the medication to someone else via direct contact.
TRT is currently available as a skin patch called Androderm. They have been FDA-approved since 1953, but there are no generic options.
Starting dose is 1 patch a day which releases 4 mg of testosterone in the course of 24 hours. The price per patch is about $22, which means that the monthly cost of the therapy is $660.
Testopel is the only FDA-approved form of testosterone pellets, and they require subcutaneous implantation in order to continuously release testosterone in your bloodstream over the course of a few months.
Therefore, pellets are administered once every few months, but the procedure requires a visit to your medical doctor.
It has been FDA-a approved since 1972 and is manufactured by Endo Pharmaceuticals. There isn’t a generic option available.
The price for ten Testopel pellets is about $1100, and the recommended dosage is 150-450 mg of Testopel, implanted every 3-6 months.
Considering the fact that one pellet contains 75 mg of testosterone, the average monthly cost of using Testopel is about $100-200.
Both pellets and patches may also increase the levels of DHT in the body to a larger extent compared to other forms since there is a high concentration of 5α-reductase enzyme in the human skin.
Oral testosterone cost
Currently, testosterone undecanoate is the only orally available and FDA-approved form of testosterone. It has a much lower absorption rate compared to other forms of TRT, and the capsules must be taken several times a day.
While some forms of oral androgens can also lead to serious side effects such as liver toxicity, testosterone undecanoate appears to be safe.
There are 3 FDA-approved brands, called Tlando, Jatenzo, and Kyzatrex, and there are no generic options. Depending on the brand, the monthly cost of oral testosterone undecanoate can vary from $100 to $1000.
Tlando was approved by the FDA in 2022. Each of the oral capsules contains 112.5 mg of undecanoate, and the cost of a supply of 120 capsules is around $750. Considering the fact that the recommended dosage is 4 capsules a day (usually 2 in the morning and 2 in the evening) then, the monthly cost is about $750.
Kyzatrex was also first approved in 2022. The cost for Kyzatrex is around $210 for a supply of 120 capsules. Considering the fact that a capsule of Kyzatrex contains about 100 mg of undecanoate and the recommended daily dosage is 2-4 capsules, the monthly cost of the therapy is about $100-200.
Jatenzo was first approved by the FDA in 2018. The medication comes in oral capsules containing 158 mg and costs around $1000 for a supply of 120 capsules. The recommended dosage is about 316 to 792 mg a day, so the cost of the therapy with Jatenzo is about $500-1000 per month.
Cost-effectiveness comparison of TRT forms
All FDA-approved medications for TRT have a comparable safety profile and effectiveness.
However, different forms and brands have different cost-effectiveness, which is determined by the relationship between the monthly cost as well as how quickly and reliably the medication can increase your testosterone levels.
A faster and more reliable increase in your serum T levels means a quicker relief of your symptoms.
In general, testosterone injections lead to the fastest increase in serum T. They are also relatively affordable, provide great bioavailability, and are the easiest to dose, especially for new patients, which puts them on top in terms of cost-effectiveness.
This is why studies also show that testosterone injections are often the most preferred form of TRT by both patients and medical professionals.
Below is a comparison table for the cost-effectiveness and safety of different TRT forms
|Form of TRT||Cost-effectiveness||Ease of use||Safety|
|Injections||$50 - $1000 per month; high absorption; easy to dose||Can be self-applied weekly/monthly||Local reactions possible|
|Gels||$200 - $1200 per month; variable absorption; difficult to dose||Must be self-applied daily||A higher increase in DHT; Risk of transmitting the medication to women and children|
|Pellets||$100-200 per month; high absorption; difficult to dose||Requires medical visits every few months||A higher increase in DHT; Local reactions possible; Risk of expulsion|
|Patches||$600-700 per month; variable absorption; difficult to dose||Must be self-applied daily||A higher increase in DHT|
|Pills||$100-1000 per month; low absorption; easy to dose||Must be taken several times a day||Higher risk of gastrointestinal discomfort|
Is the cost of testosterone different for FTM?
Gender-affirming hormone therapy for female-to-male (FTM) patients requires testosterone medications for them to achieve the desired virilization and masculinization.
All forms of testosterone medications are suitable for FTM patients, but the most widely prescribed form is testosterone injections, followed by transdermal and oral testosterone.
Testosterone injections are most commonly prescribed due to the fact that they are the most affordable and easier to dose.
Unfortunately, insurance companies do not cover gender-affirming hormone therapy (GAHT). Studies show that the lack of insurance for GAHT is a common cause for taking illegal forms of testosterone amongst FTM patients.
The main difference between TRT for hypogonadism and gender-affirming hormone therapy for FTM patients is the purpose of the intervention.
TRT dosage is often adjusted according to the severity of the symptoms, and their successful management, while GAHT dosage depends on what degree of masculinization is desired by the patient.
Regardless of these differences, usually, the recommended dosage for FTM patients is similar to that for hypogonadal men. That’s because the goal of GAHT is to achieve serum testosterone levels in the range of 300 – 1000 ng/dl, which is typical for healthy males.
Therefore, the expected cost of GAHT is also similar to that of TRT, and an FTM patient may have to pay anywhere between $50 to $1000 a month, depending on the form and brand of the medication.
Get a free consultation with our medical expert for any questions about hormone replacement therapy