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Evaluating incidence, prevalence, and treatment trends in adult men with hypogonadism in the United States

International Journal of Impotence Research volume 34, pages 762–768 (2022)Cite this article

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Abstract

No extensive studies have investigated current diagnosis and treatment trends of hypogonadism (HG) in adult men in the United States. Using a comprehensive commercial insurance database, we surveyed current trends in incidence, prevalence, and treatment of hypogonadism in the United States. We analyzed insurance claims data from 2008–2017 using the IBM MarketScan™ Commercial Claims and Encounters database for men ≥18. Overall, we estimated annual incidence at 16.1 cases per 100,000 person-years, with the highest incidence seen among men 35–44 years at 21.5 cases per 100,000 person-years (IRR 1.83; 95% CI 1.63, 2.06, p < 0.001) and among those living in the Southern United States at 22.6 cases per 100,000 person-years (IRR 1.96; 95% CI 1.76, 2.18, p < 0.001). The prevalence of HG across the study period increased from 0.78% to 5.4%, while treatment rates decreased from 32.9% to 20.8%. These study findings provide a large-scale view of current diagnosis rates and treatment of hypogonadism in adult men in the United States. Despite the increase in prevalence of disease, there is an observed decline in treatment rates after diagnosis. Further investigations are needed to identify factors driving the observed decline in healthcare utilization among men with hypogonadism.

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Fig. 1: Annual treatment rate of hypogonadism stratified by hormone formulation/route.

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SQL and R codes used to generate and analyze data are available from the corresponding author upon reasonable request.

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Acknowledgements

AWP is a National Institute of Health (NIH) K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the National Institute of Diabetes and Digestive and Kidney Diseases. This work is also supported in part through a Urology Care Foundation Rising Stars in Urology Award (to AWP). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.

Funding

AWP is a National Institute of Health (NIH) K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the National Institute of Diabetes and Digestive and Kidney Diseases. This work is also supported in part through a Urology Care Foundation Rising Stars in Urology Award (to A.W.P). We thank the Surgical Population Analysis Research Core (SPARC), University of Utah, for its role in facilitating data collection, database management, and statistical analysis. This study was supported by an unrestricted grant provided by Endo Pharmaceuticals Inc, Malvern, PA.

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Authors and Affiliations

  1. Baylor College of Medicine, Houston, TX, USA

    Jeremy M. Auerbach

  2. Department of Surgery, Division of Urology, University of Utah Health Science Center, Salt Lake City, UT, USA

    Odinachi I. Moghalu, James Hotaling & Alexander W. Pastuszak

  3. Department of Surgery, Surgical Population Analysis Research Core, University of Utah Health Science Center, Salt Lake City, UT, USA

    Rupam Das, Joshua Horns, Alexander Campbell & James Hotaling

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  1. Jeremy M. Auerbach
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  4. Joshua Horns
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  7. Alexander W. Pastuszak
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Contributions

JA was responsible for the interpretation of results, manuscript writing, and editing. OM was responsible for study design, interpretation of results, manuscript writing, and editing. JH, RD, and AC were responsible for data analysis, interpretation of results, and manuscript revision. AWP and JMH aided in study design and planning, result interpretation, and manuscript revision.

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Correspondence to Jeremy M. Auerbach or Alexander W. Pastuszak.

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Competing interests

Dr. Pastuszak declares the following conflict(s) of interest. 1 Endo Pharmaceuticals – advisor, consultant, speaker, research support, fellowship support. 2 Antares Pharmaceuticals – advisor. 3 Bayer AG – speaker. 4 Inherent Biosciences – advisor. 5 Allotrope Medical – advisor. 6 Woven health – founder and leadership role. 7 Vault Health – a leadership role. Dr. Hotaling declares the following conflict(s) of interest. 1 Endo Pharmaceuticals – educational and research grants. 2 Boston Scientific – educational grants. 3 StreamDX, Nanonc, Andro360 – founder/own equity (early startups). 4 Inherent Biosciences – own equity. 5 Turtle health – advisor. Mr. Auerbach, Dr. Moghalu, Mr. Das, Dr. Horns and Mr. Campbell have no conflicts of interest to declare.

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Auerbach, J.M., Moghalu, O.I., Das, R. et al. Evaluating incidence, prevalence, and treatment trends in adult men with hypogonadism in the United States. Int J Impot Res 34, 762–768 (2022). https://doi.org/10.1038/s41443-021-00471-2

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