Two authors writing in The BMJ have called for a national reporting framework covering private testosterone prescribers and dispensing pharmacies in the UK. The analysis, published on 14 October 2026 by Stephen Atkin of the Royal College of Surgeons in Ireland Medical University of Bahrain and Eric Kilpatrick of Manchester University NHS Foundation Trust, sets out what the rapid growth of commercial testosterone services means for the NHS. NHS community dispensing of testosterone rose 52% between 2020/21 and 2024/25, the authors report, and in England prescriptions of testosterone gel for women aged 50 and over rose roughly tenfold between 2015 and 2022. The authors put private subscription pricing at between £100 and £375 a month. The piece is a commentary rather than new research, and the authors are explicit that the true scale of private provision is unknown, because private prescriptions are not recorded nationally.
Where the authors say the model falls short
Atkin and Kilpatrick argue that subscription services built around the marketing of non-specific symptoms “are unsuitable to handle the complexity of the diagnostic process and risk unnecessary lifelong treatment”, with the resulting monitoring burden falling on the NHS. They note that up to a fifth of men over 50 may report symptoms of deficiency while fewer than 1% receive NHS treatment, a gap commercial providers have moved into. They also point out that professional societies work to differing treatment thresholds, and that it is not established how consistently private providers repeat diagnostic testing. Their proposed framework would record indications, patient numbers, monitoring and transfers of care.
What this means in practice
Nothing in this analysis changes what is on sale over the counter. Testosterone is a prescription-only medicine in the UK and is not sold as a food supplement, so the commentary does not bear on the products on an ordinary supplement shelf. A monthly subscription wrapped around a clinical decision can blur who is accountable for the diagnosis and for the follow-up testing, and the figures they cite are for dispensing volumes rather than for outcomes. The authors want that activity recorded and auditable, which they argue would produce “transparent prescribing and demonstrable adherence to evidence based care” while “protecting patients while preserving access to effective treatment”. The full analysis is on The BMJ website.
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