Health Technology Assessment in Action (May 2020)
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 most important reasons of short stature in children, which can be treated by early diagnosis. Stature is a good measure for assessing a child's overall growth and health, and height can affect one's psychosocial and social well-being. Human Growth Hormone (HGH) has extensive effects on biological processes, and helps to influence height. Due to the high cost of growth hormone GH drugs, in most countries it is prescribed according to scientific indications. Methods: The present study is a systematic review. From the beginning of 2002 to February 2019, by searching Web of Science, PubMed, Scopus, SID, Embase and Magiran databases, related studies in the scope of health technology assessment and Economic evaluation were reviewed. Finally, 11 related studies were entered the study. Results: The use of GH therapy was effective in increasing the patients' life quality. The growth of children treated with GH was more than 2.5 cm per year more than untreated children. Furthermore, the results of the studies indicated the cost-effectiveness of using GH. So that the cost of each centimeter increase in height is on average US $ 20,000, and the incremental cost-effectiveness 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) is different. The highest cost efficacy per kali is 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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