scholarly journals Cost effectiveness of proton versus photon radiation therapy with respect to the risk of growth hormone deficiency in children

Cancer ◽  
2015 ◽  
Vol 121 (10) ◽  
pp. 1694-1702 ◽  
Author(s):  
Raymond Mailhot Vega ◽  
Jane Kim ◽  
Abby Hollander ◽  
Jona Hattangadi-Gluth ◽  
Jeff Michalski ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Radiation Therapy ◽  
Cost Effectiveness ◽  
Growth Hormone Deficiency ◽  
Photon Radiation ◽  
Hormone Deficiency

Cost-effectiveness analysis of proton versus photon therapy with respect to risk of growth hormone deficiency.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17553-e17553
Author(s):  
Raymond Mailhot ◽  
Jane Kim ◽  
Abby Hollander ◽  
Jeff M. Michalski ◽  
Nancy Tarbell ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cost Effectiveness ◽  
Growth Hormone Deficiency ◽  
Proton Therapy ◽  
Cost Effective ◽  
Childhood Cancer Survivors ◽  
Cns Tumors ◽  
Hormone Deficiency ◽  
Health States ◽  
Life Years

e17553 Background: Proton therapy has been endorsed as a radiotherapy (RT) modality with the potential to avert many RT associated comorbidities. Currently, few proton centers exist, and no evidence-based data as yet adequately informs allotment of care. Childhood cancer survivors of central nervous system (CNS) malignancies have high prevalences of growth hormone deficiency (GHD) after hypothalamic exposure, notable for its cost of treatment greater than $10,000/year. We propose methodology to help guide proton referral of pediatric patients with CNS tumors through cost-effective analysis comparisons for proton and photon hypothalamic received dose. Methods: A Markov cohort model was designed to assess the expected costs and effectiveness for specific RT doses to the hypothalamus. Patients entered the model receiving proton or photon RT for CNS tumors at four and twelve years of age and were followed for 60 more years of life. Patients could experience two health states: GHD or healthy. Risk of GHD was based on data by Merchant et al. Costs were measured in USD and captured cost of GHD and cost of RT. Cost of proton course relative to photon was estimated at $160K. Effectiveness was measured in quality-adjusted life years (QALYs). The main outcome measure used for comparison was the incremental cost-effectiveness ratio (ICER). We assumed a societal willingness to pay threshold of $50,000/QALY. Results: Data were used to generate tables incorporating the differential cost of proton RT to project ICERs for different combinations of hypothalamic RT dose as displayed in the Table below. Conclusions: Despite the high cost of proton therapy, the cost of GHD alone can yield proton RT a cost-effective (even cost-minimizing) strategy when compared to photon RT. This work provides a guide for identifying a set of patients for which proton therapy is particularly cost-effective. [Table: see text]

Economic and social aspects of growth hormone therapy in children and adults with growth hormone deficiency. Literature review

2016 ◽  
Vol 62 (2) ◽  
pp. 61-68
Author(s):  
Maria V. Vorontsova
Keyword(s):  
Quality Of Life ◽  
Growth Hormone ◽  
Cost Effectiveness ◽  
Growth Hormone Deficiency ◽  
World Wide ◽  
Growth Hormone Therapy ◽  
The State ◽  
Hormone Deficiency ◽  
Social Aspects

In the Russian Federation growth hormone therapy (GHT) for children with growth hormone deficient children is funded from the state budget. The clinical effectiveness of GHT with human recombinant growth hormone was proven repeatedly in both world wide and Russian practice. Nevertheless, the economic and financial aspects of this therapy are in need of a detailed analysis. Such an analysis could serve as a possible instrument for well-grounded weighed decisions in the health care sector. One such instrument is a cost-effectiveness analysis, which involves the calculation of cost-effectiveness ratios or incremental cost-effectiveness ratios for determining the economic viability of new medical technologies or programs. Moreover, social aspects of GHT are also of great importance. A physician or a health care manager need to be informed about the effect of any therapy, including GHT, on the patient’s quality of life. While there is an overall agreement about the necessity and positive effect of GHT in children, the question remains somewhat disputable in the case of adult patients with growth hormone deficiency. Both world wide and in Russia there is no uniform agreement as to weather treatment is necessary in all cases of adult growth hormone deficiency, or weather treatment should be subsidized and provided for by the state or other financial resources, or weather GHT has indeed such a profound effect on the patient’s quality of life. The present article reviews the state of discussion around these questions to date for both children and adult patients. Available data on the cost-effectiveness analyses of GHT from several countries is highlighted and the effects of GHT on the quality of life are reviewed. 

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

2021 ◽  
Author(s):  
Mohsen Pakdaman ◽  
Fahimeh Golmakani ◽  
Hamid Reza Dehghan ◽  
Reza Valagohar ◽  
Akram Beik Yazdi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Growth Hormone ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Hormone Deficiency ◽  
Control Group ◽  
Cost Efficacy ◽  
The Cost

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 cost effectiveness 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.

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