Prevalence studies have shown that nearly 39% of men over the age of 45 presenting to primary care offices have signs and symptoms of hypogonadism. While prior studies on male hypogonadism have demonstrated a significant economic and quality-of-life burden, these previous trials have not evaluated the direct or indirect impacts of hypogonadism on healthcare utilization and costs in US men.
A recent study sought to compare direct healthcare and indirect (disability leave or medical absence) costs between privately insured US men with hypogonadism and controls without hypogonadism. The study included a sample size of 4,269 employed men ages 35-64 with 2 or more hypogonadism diagnoses. Employees and controls had a mean age of 51 years.
This study demonstrated that men with hypogonadism had higher statistically significant comorbidity rates compared to controls with respect to hyperlipidemia, hypertension, musculoskeletal pain, and human immunodeficiency virus infection, which are directly related to increased financial costs. Men with hypogonadism had higher inpatient hospitalizations, emergency department visits, and prescription drug use compared to controls. However, the inpatient and emergency department evaluations did not substantially increase annual medical care utilization. Men with hypogonadism had higher direct and indirect costs compared to controls, $14,118 versus $5,272, respectively.
The authors admit that this study has limitations relative to retrospective claims data analysis. For example, controlling for a comorbid diagnosis of obesity is challenging secondary to infrequency of reporting in billing claims. Thus, the authors used 2 or more comorbid conditions associated with hypogonadism in the test group. It is also probable that patients with additional comorbidities are likely to be labeled as having hypogonadism as an incidental results of laboratory evaluation. Since the analysis in this study examined men who held private insurance, it limits the ability to generalize across populations of hypogonadal men with Medicare or Medicaid.
Reference: Kaltenboeck A, Foster S, Ivanova J, et al. The direct and indirect costs among US privately insured employees with hypogonadism. J Sex Med 2012;9:2438-2447.