The Cost Problem With Testosterone

As a prescriber, you already know that getting a patient diagnosed with hypogonadism is only half the battle. The other half is making sure they can actually afford and access their Testosterone prescription — especially during the ongoing shortage.

Cost is one of the top reasons patients abandon TRT. While generic Testosterone Cypionate injections are relatively affordable, many patients end up on brand-name gels, patches, or oral formulations that can cost $400–$900/month without insurance. Even with insurance, prior authorization requirements and step therapy protocols create barriers.

This guide covers every savings lever available to your patients — from coupon cards to patient assistance programs to prescribing strategies that keep costs down.

Start With Generic Testosterone Cypionate

The single most impactful thing you can do for your patient's wallet is prescribe generic Testosterone Cypionate injection. It's clinically effective, well-established, and by far the most affordable formulation:

• Cash price: $30–$110 per vial without insurance
• With a coupon (GoodRx, SingleCare): As low as $14–$30
• Insurance coverage: Most plans cover generic Testosterone Cypionate, often with low copays after prior authorization

Compare that to brand-name options:

• AndroGel (brand gel): $400–$900/month
• Jatenzo (oral): $500–$900/month
• Androderm (patch): $200–$500/month
• Xyosted (subcutaneous autoinjector): $500–$700/month

If a patient can self-inject (or learn to), generic Testosterone Cypionate is the clear first choice from a cost perspective. Generic Testosterone gel (1.62%) is a reasonable second option at $40–$150/month with a coupon for patients who won't inject.

Coupon Cards and Discount Programs

For uninsured or underinsured patients — or those with high copays — pharmacy discount cards can dramatically reduce out-of-pocket costs. Here are the most effective options for Testosterone:

Free Pharmacy Coupons

• GoodRx — Often has the lowest prices for generic Testosterone Cypionate. Patients can search at goodrx.com and show the coupon at any participating pharmacy.
• SingleCare — Competitive pricing, especially at certain chains. Available at singlecare.com.
• RxSaver — Another reliable option for comparing prices across pharmacies.
• Optum Perks, BuzzRx, Inside Rx — Additional free coupon programs worth checking.

These coupons work at most major pharmacy chains and are free for patients to use. They cannot be combined with insurance but are often cheaper than insurance copays for generic Testosterone.

Manufacturer Copay Cards (Brand-Name Products)

If a patient needs a brand-name formulation, manufacturer savings programs can help:

• AbbVie AndroGel Savings Card — Eligible commercially insured patients can save up to $100/month.
• Xyosted Copay Card — Antares Pharma offers copay assistance for eligible patients.
• Jatenzo Savings Program — Clarus Therapeutics provides savings for eligible commercially insured patients.
• Aveed Copay Assistance — Available for the long-acting injectable.

Important: These programs typically exclude patients on government insurance (Medicare, Medicaid, Tricare, VA). For those patients, you'll need to look at patient assistance programs instead.

Patient Assistance Programs (PAPs)

For patients who are uninsured, underinsured, or on a fixed income, manufacturer-sponsored PAPs can provide Testosterone at no cost:

• AbbVie myAbbVie Assist — Provides AndroGel at no cost to qualifying uninsured or underinsured patients. Applications are available at abbvie.com.
• Pfizer RxPathways — May assist with Depo-Testosterone for eligible patients.
• Antares Pharma assistance — Offers help with Xyosted for qualifying patients.

Additional resources for finding PAPs:

• NeedyMeds (needymeds.org) — Comprehensive database of patient assistance programs
• RxAssist (rxassist.org) — Search tool for PAPs by medication
• RxHope (rxhope.com) — Another PAP search resource

The application process typically requires proof of income and insurance status. Consider having your office staff assist patients with these applications — it can make the difference between a patient staying on treatment and abandoning it.

Insurance Navigation Strategies

Helping patients navigate insurance for Testosterone often requires some advocacy on your end:

Prior Authorization

Most insurance plans require prior authorization for Testosterone, which typically means:

• Two documented low Testosterone levels (total T below 300 ng/dL) on morning blood draws
• Documentation of symptoms consistent with hypogonadism
• Sometimes exclusion of reversible causes (obesity, medications, etc.)

Having this documentation ready before prescribing speeds up the process significantly. Submit the PA proactively rather than waiting for a denial.

Step Therapy Appeals

Many plans require step therapy — typically starting with generic Testosterone Cypionate injections before approving gels, patches, or oral formulations. If a patient has a legitimate clinical reason for a non-injection formulation (e.g., needle phobia, inability to self-inject, injection site reactions), document this thoroughly and include it in your appeal.

Formulary Awareness

Check your patient's formulary before prescribing. If their plan covers generic Testosterone gel but not AndroGel, prescribe the generic. If they cover Androderm patches but not oral capsules, work within what's covered. A quick call to the insurance company or a check in the plan's formulary lookup tool can save weeks of back-and-forth.

Compounding Pharmacies

Compounding pharmacies can prepare Testosterone Cypionate at competitive prices and are often unaffected by the same supply issues as commercial manufacturers. This is especially valuable during the current Testosterone shortage.

Key considerations:

• Compounded Testosterone is not FDA-approved but is legal when prescribed by a licensed provider
• Costs typically range from $30–$80 for a multi-month supply
• Quality varies — recommend pharmacies that are PCAB-accredited or FDA-registered 503B outsourcing facilities
• Insurance typically does not cover compounded products

Telehealth TRT Clinics: A Double-Edged Sword

Many of your patients may ask about or already be using telehealth TRT providers (Hims, Ro, Hone, Vault, etc.). These clinics have streamlined the process significantly but can vary in quality and cost.

As a provider, it's worth knowing:

• Most telehealth TRT clinics charge $100–$250/month all-in (consultation + medication + shipping)
• They typically supply generic Testosterone Cypionate through partner pharmacies
• Quality of monitoring varies — some do excellent follow-up labs, others are lax
• Patients may come to you after starting with a telehealth clinic and wanting more comprehensive care

Prescribing Tips That Save Patients Money

Small prescribing decisions can have a big impact on cost:

1. Prescribe 10 mL vials when possible — The per-mL cost is significantly lower than 1 mL vials. A 200 mg/mL 10 mL vial can last months and costs $40–$90.
2. Write for generic by drug name — Avoid brand names on the prescription to ensure the pharmacy fills generic.
3. Consider dose optimization — Smaller, more frequent doses (e.g., twice-weekly subcutaneous injections) may provide more stable levels and could use less total Testosterone over time.
4. Recommend coupon cards at the point of prescribing — Don't assume patients know about GoodRx or SingleCare. Mention it during the visit.
5. Provide backup pharmacy options — Given the shortage, having 2–3 pharmacy options ready helps patients avoid gaps in treatment.

Help Patients Find Testosterone in Stock

Cost savings don't matter if the patient can't find the medication. With the ongoing Testosterone Cypionate shortage, directing patients to MedFinder can save them hours of phone calls. MedFinder shows real-time Testosterone availability at pharmacies nationwide.

You can also register at medfinder.com/providers to access provider-specific tools for helping your patients locate medications in stock.

The Bottom Line

Helping patients afford Testosterone is a team effort between prescriber, pharmacy, and patient. By defaulting to generic Testosterone Cypionate, proactively managing prior authorizations, connecting patients with coupon cards and PAPs, and staying aware of the shortage landscape, you can keep more patients on treatment and improve outcomes.

For more provider-focused guidance, see our guides on the Testosterone shortage for prescribers and helping patients find Testosterone in stock.