Cost-effectiveness of Growth Hormone and its Consumption Indications: A Systematic Review of Economic Evaluation Studies

Abstract

Context: Growth hormone deficiency (GHD) is one of the main reasons for short stature in children, which can be treated by early diagnosis. Stature is an appropriate measure to assess a child’s overall growth and health, and one’s height can affect his psychosocial and social well-being. Human growth hormone (HGH) has extensive effects on biological processes as well as height. Due to the high cost of growth hormone (GH) drugs, in most countries GH is prescribed according to scientific indications.

Methods: The present study was a systematic review, which examined PICOD- based case studies published from the beginning of 2002 to February 2019 on Web of Science, PubMed, Scopus, SID, Embase, and Magiran databases in the field of health technology assessment and the economic evaluation. According to the inclusion criteria, 11 relevant articles were selected in the present study.

Results: The findings showed that GH therapy was effective in increasing patients’ quality of life, and that the growth rate of children treated with GH was more than 2.5 cm per year, in comparison to the control group. Furthermore, the results of the studies indicated the cost-effectiveness of GH since the cost of each centimeter height increase in children was on average US $20,000, and the incremental costeffectiveness ratio varies based on QALY’s criteria in studies for various indications (Turner syndrome, idiopathic short stature, growth
hormone deficiency, Prader Willi syndrome, Infants small for gestational age (SGA), chronic renal failure (CRF) and (SHOX-D). The highest cost efficacy per QALY was for growth hormone deficiency (from £20,000 to £30,000), and the lowest cost efficacy is for Prader Willi (from £55,000 to £135,000).

Conclusions: Studies showed that GH increases the height of the children treated with GHD, compared to the control children; hence, the use of growth hormone is recommended after doing the experiments for all children with GHD. This issue can be considered by health policy makers to implement in healthcare programs.