TRT in Australia: PBS Coverage, Prescriptions, and Cost Guide (2026)

The PBS Pathway

Step 1: Blood tests

• Total testosterone below 8 nmol/L on two separate occasions.
• Tests should be at least 4 weeks apart.
• Morning timing is critical — testosterone drops 20-40% by afternoon.
• Your GP can order these tests. Medicare covers the blood work.

Step 2: Endocrinologist referral

Most GPs will refer you to an endocrinologist before initiating TRT. The specialist will confirm the blood results, assess symptoms, rule out secondary causes, and check LH/FSH to distinguish primary from secondary hypogonadism.

Step 3: Authority prescription

PBS-subsidised testosterone requires an authority prescription — your doctor needs to call or submit electronically to Services Australia to get approval. This is a one-time process per treatment course.

Testosterone Brands Available in Australia

Reandron 1000 (testosterone undecanoate)

• 1000mg testosterone undecanoate in 4mL — the Australian equivalent of Nebido.
• Injection schedule: Every 10-14 weeks (typically 12 weeks once at steady state).
• Must be given as a slow deep intramuscular injection by a healthcare professional.
• PBS: $31.60 (general) / $7.70 (concession) per injection.
• Pros: Lowest injection frequency, very stable levels once at steady state.
• Cons: Long washout if side effects occur, requires clinic visit, less dose flexibility.

Primoteston Depot 250 (testosterone enanthate)

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• 250mg testosterone enanthate in 1mL ampoule.
• Injection schedule: Every 1-3 weeks (commonly every 2 weeks on PBS).
• Can be self-administered after training.
• PBS: $31.60 (general) / $7.70 (concession) per ampoule.
• Pros: Flexible dosing, can self-inject, well-established with predictable PK.
• Cons: More frequent injections than Reandron. Glass ampoules can be fiddly.

Sustanon 250

• Four-ester testosterone blend in 1mL ampoule (same as UK).
• Every 2-3 weeks. PBS-listed.
• Multi-ester blend provides both fast and sustained release.
• Complex pharmacokinetics, significant peaks and troughs with fortnightly dosing.

Compounding pharmacy options

Australia has a well-established compounding pharmacy system. Common compounded preparations:

• Testosterone cream (typically 50-100mg/mL, applied daily to forearms or scrotum)
• Testosterone troches (sublingual lozenges)
• Testosterone cypionate (not commercially available in Australia but can be compounded)

Compounded preparations are not PBS-subsidised and typically cost $80-150/month.

Cost Comparison

Monitoring Requirements

• Blood work every 6 months initially, then annually once stable.
• Tests to monitor: Total testosterone, free testosterone, SHBG, haematocrit (FBC), PSA, liver function, lipids, oestradiol.
• Haematocrit threshold: Australian guidelines flag concern at haematocrit above 0.52 (52%). Action required above 0.54 (54%).
• PSA: Annual monitoring. Rising PSA requires urology referral.

Blood donation for haematocrit management

The Australian Red Cross Lifeblood accepts blood donations. Men can donate whole blood every 12 weeks. If your haematocrit is trending high on TRT, regular blood donation is the most common management strategy. TRT use does NOT disqualify you from donating.

Tracking Your TRT Protocol

Whether you are on 12-weekly Reandron, fortnightly Primoteston, or daily compounded cream, keeping track of injections, doses, and blood work matters — especially for PBS authority renewals where documented compliance helps. Regimen works with any testosterone preparation and injection interval available in Australia.