RT Journal
A1 Lee JM, Davis MM, Clark SJ, Hofer TP, Kemper AR
T1 EStimated cost-effectiveness of growth hormone therapy for idiopathic short stature
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2006
FD March 1
VO 160
IS 3
SP 263
OP 269
DO 10.1001/archpedi.160.3.263
UL http://dx.doi.org/10.1001/archpedi.160.3.263
AB Objective 
    To estimate the cost-effectiveness of growth hormone (GH) therapy for idiopathic short stature (ISS).Design 
    Cost-effectiveness analysis.Setting 
    Decision model.Patients 
    A cohort of 10-year-old prepubertal boys with ISS treated with GH.Interventions 
    Comparison of children treated for 5 years with GH therapy vs children receiving no intervention.Main Outcome Measures 
    Incremental cost per child, incremental growth per child, and incremental cost per inch of final height gain.Results 
    The estimated incremental cost-effectiveness ratio of GH therapy for ISS in the base case analysis compared with no therapy was $52 634 per inch (per 2.54 cm), or $99 959 per child, reflecting an incremental growth of 1.9 in (4.8 cm). Alternate treatment strategies such as increased duration of GH treatment and high pubertal dosing of GH did not substantially improve the cost-effectiveness ratio. Probabilistic sensitivity analyses showed that growth variability in response to GH had the greatest impact on the cost-effectiveness of GH therapy.Conclusions 
    Targeted treatment of children with ISS with the greatest potential for growth appears critical for maximizing cost-effectiveness of GH treatment. However, the significance of the cost per inch is difficult to judge until the utility gains associated with height gain after GH therapy for ISS can be ascertained.