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

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.