Friday, 2 March 2012

They don't make it easy

Testosterone ampules, vital for Trans mens' health (if only to stop their bones getting brittle) has been quietly de-listed from the Australian Pharmaceutical Benefits Scheme (PBS), resulting in a quadrupling in price, and ten times the price for those on low incomes with a Health Care card, entitling them to reduced costs on PBS medications.

Apparently it may be because Transsexuality isn't considered to exist as far as the Dept of Health is concerned (there are no drugs on the PBS for treating it), and for non-Trans and non-Intersex men, other alternatives are available. Intersex they're clueless about, and they apparently don't realise what a catastrophic effect this will have on Trans and Intersex mens' health.

This is suspiciously coincidental with the UK National Health Service (NHS) recently putting Testosterone on the "Red List" - meaning it can no longer be prescribed for Trans men (only non-Trans and non-Intersex) by GPs. They have to now obtain the scripts from specialised Gender Clinics - who have no budget for them, so can't provide them. Testosterone has thus been effectively de-listed in the UK too. This follows on from the UK NHS delisting of estrogen implants, which led to the last commercial manufacturer left in the world ceasing to make them last year. That too was based on substitutes being available for everyone except Trans and Intersex women.


Anonymous said...

In California, one state rep, who is a Democrat btw, wants the state legislature to declare SRS medically unnecessary, actual medical community be damned:

M Italiano said...

I can only practice medicine in India where I can prescribe estriol. No physician in the U.S.A. can prescribe estriol because the FDA does not permit this. Tell me that this is not political FDA nonsense.

M Italiano, MBBS (AM)

Dr Rosie Jones said...

Implants in Australia have been lost from the PBS because MSD decided to cease production. The stated reason for doing this was that " it was no longer profitable". I am now having them made locally by a compounding pharmacist with no financial assistance from the PBS.

Zoe Brain said...

Dr Jones - could you please contact me privately on this? There must be 50 ways to love your liver, and having to take 12-16mg oral E.Valerate daily long-term is not one of them. My GP has been trying to source 200mg or even 100mg implants since production ceased, not just for me alone.

With an implant, I might be able to get my E2 levels past 500 pmol/l again. It would be nice not to get the hot flushes, body hair growth etc. I know many Intersex people are fine with their own bodies, but sometimes I really wish I was closer to a standard factory model.

Anonymous said...

You say "testosterone ampules" that being a specific form of testosterone delivery. Is it all testosterone products or just those in ampule form?

That form of testosterone is injected, but there are other injectables that don't come in ampules.

Anonymous said...

And you also mention "non-intersex" what are "intersex" and "non-intersex" men who take testosterone?

I expect there are millions of men who take testosterone to improve their libido who have regular chromosomes.

Anonymous said...
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Tab said...

The situation in the UK may not be as bad as you describe it - I'm a trans man who happens to work in the NHS, and everyone in my trust was recently emailed a link to the latest list of controlled drugs.

All drugs prescribed for people with gender dysphoria are, in my part of the country at least, on the Amber List. This means that somebody at a gender clinic has to prescribe them to begin with, but after discharge from the clinic, the GP can take over their care. This has always been the case anyway, as long as the gender clinic system has existed.

And gender clinics definitely *do* have the budget to start prescribing hormones, because I started on T in November last year. Unless something's changed radically in the past three months that I wasn't aware of.

It is something of a postcode lottery, though, and I can't speak for people outside of my own area.

Zoe Brain said...

"Unless something's changed radically in the past three months that I wasn't aware of."

Please check, because 3 months ago, these were on the amber list.

See Jane Fae's blog on the subject.

Anonymous said...

It is only Sustanon 250 that has been delisted, it is manufactured by MSD - who had "had problems with manufacturing" it in the second half of last year.
Men requiring testosterone do have other options including gel and implants and two other injectable forms. The differences between the injectible forms are the oil base used and the time taken to release testosterone from the oil.
Frankly, some people "just get on better" with one form or another.

The big issue here is the quadrupling in price after it was made available again. Prior to being delisted, Sustanon and Primoteston both cost about $33-34 (to the PBS) and $35.40 to the consumer. Many people made various temporary arrangements while Sustanon was unavailable, on good faith that it was a "manufacturing issue" and are now having to make choices about a permanent change in their medication.