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Limited coverage drugs – testosterone injection

Last updated on September 27, 2024
Generic name testosterone cypionate or enanthate or propionate 
Strength 100 mg/ mL
Form  vial

Criteria

Approval period

For the treatment of testosterone deficiency in one of the following diagnoses:

  • hypogonadism

OR

  • orchiectomy

OR

  • undescended testes

OR

  • Klinefelter's syndrome

OR

  • female-to-male (gender) transformation

OR

  • Pituitary tumor

OR

  • removal of pituitary gland
 Indefinite

OR

  

For the indication of:

  • surgery of pituitary gland AND where low testosterone levels have been documented

OR

  • AIDS-wasting syndrome AND where low testosterone levels have been documented

 

Indefinite

Practitioner exemptions

  • None

Special notes

  • For any cancer-related condition, please contact the British Columbia Cancer Agency at (604) 877-6098 ext. 4610

Special Authority requests