Testim Shortage: What Providers and Prescribers Need to Know in 2026

If your patients have been reporting difficulty filling Testim prescriptions, the access challenges they describe are real — even though Testim is not on the FDA's formal drug shortage list as of 2026. As a prescriber, understanding the current supply landscape, access barriers, and available alternatives is essential for minimizing treatment interruptions and supporting your patients through these challenges.

Current Testim Availability: What the Data Shows

Testim (testosterone 1% gel) is not on the FDA's formal drug shortage database as of early 2026. However, clinicians across the country are reporting patient-level access challenges driven by:

Limited pharmacy stocking: Most chain pharmacies prioritize generic testosterone gel and AndroGel. Testim is often a special-order item at the pharmacy level.

Cost barriers: Brand-name Testim costs $380–$760/month retail without insurance. Most Medicare Part D and commercial plans require prior authorization and may not cover it.

DEA Schedule III ordering constraints: Pharmacies face DEA-regulated ordering limits on controlled substances, which can affect stocking levels for lower-turnover products like Testim.

Increased TRT demand: Telehealth TRT clinic growth and broader Low T awareness have increased testosterone prescriptions across all formulations, straining supply.

Injectable shortage spillover: Testosterone Cypionate has been in intermittent shortage since early 2023 (still on the ASHP list as of April 2026), pushing more patients toward gel formulations and increasing gel demand.

Prescribing Implications and Clinical Considerations

Allowing Generic Substitution

Generic testosterone 1% gel is bioequivalent to Testim and widely available at most retail pharmacies. If you have not already written "substitution permitted" on Testim prescriptions, allowing generic substitution is the single most effective step to eliminate access barriers for most patients. Generic options cost as little as $87/month with GoodRx — compared to $380–$760/month for brand Testim.

Switching Protocols for Patients Who Can't Fill Testim

When patients cannot fill their Testim prescription and need to switch formulations, consider the following protocols:

Testim 1% → Generic testosterone 1% gel: Direct substitution at equivalent dose. No recalculation needed. Monitor serum testosterone in 4 weeks to confirm adequate levels.

Testim 1% → AndroGel 1.62% (or generic): Dose recalculation required due to different concentration. Typically start at 40.5 mg (1 pump) and titrate based on serum levels at 4 weeks.

Testim 1% → Fortesta 2%: Different application site (thighs). Requires dose conversion and patient education. Different pharmacokinetic profile; check serum testosterone at 4 weeks.

Gel → Testosterone Cypionate injection: Most cost-effective switch (generic $30–$110/month), but requires patient education on self-injection technique. Note: injectable testosterone is also in intermittent shortage. Provide follow-up labs in 4 weeks.

Gel → Oral testosterone (Jatenzo, Tlando, Kyzatrex): Eliminates transfer risk. Higher cost ($500–$900/month without insurance); typically require prior authorization. Good option for patients with children or partners at risk for secondary exposure.

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Monitoring Considerations During Formulation Changes

Following any formulation switch, the standard of care recommends:

Serum testosterone level (measured 2-8 hours after morning gel application) at 4 weeks post-switch

Hematocrit/CBC at baseline and 3-6 months post-switch (polycythemia risk with all testosterone formulations)

Blood pressure monitoring, particularly in patients with hypertension

PSA at baseline and per standard prostate cancer screening guidelines

Savings Programs to Share with Patients

When prescribing Testim or transitioning patients, direct them to these cost-reduction resources:

Endo Pharmaceuticals patient assistance: Available for eligible uninsured/underinsured patients. Call 1-800-462-3636.

GoodRx / SingleCare coupons: Can reduce generic testosterone gel costs to as low as $87/month. Available at most retail pharmacies.

Generic substitution: Generic testosterone 1% gel is the most cost-effective route for most patients on Testim.

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Tools to Help Your Patients Find Testim

Directing patients to the right tools can reduce your office's administrative burden and help patients stay on therapy. medfinder for Providers allows you to check pharmacy stock for Testim and alternatives in your patients' areas before sending prescriptions, reducing call-back rates and treatment gaps.

Key Takeaways for Prescribers

Testim is not in formal shortage, but pharmacy-level access problems are real

Allowing generic testosterone 1% gel substitution is the single most impactful prescribing change

Formulation switches require dose recalculation (for different concentrations) and follow-up labs

Injectable testosterone remains in intermittent shortage — don't assume it's readily available as a backup

Direct patients to savings programs and pharmacy-finding tools to minimize treatment interruptions

For a step-by-step guide to helping patients access Testim, see our companion article: How to Help Your Patients Find Testim in Stock: A Provider's Guide.