Delayed puberty cost-effectiveness of therapy: Difference between revisions
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==Overview== | ==Overview== | ||
There are limited data about cost-effectiveness of therapy in delayed [[puberty]]. The main part of the economic burden of delayed [[puberty]] is because of | There are limited data about the cost-effectiveness of therapy in delayed [[puberty]]. The main part of the economic burden of delayed [[puberty]] is because of various non-specific and specific [[blood tests]], such as [[hormone]] assay. The main treatment for the patients with [[short stature]] is [[Growth hormone|growth hormone (GH)]]. The potential cost of treating all eligible children with [[Growth hormone|growth hormone (GH)]] is approximately $40 billion dollars. | ||
==Cost-Effectiveness of Therapy== | ==Cost-Effectiveness of Therapy== | ||
* There are limited data about cost-effectiveness of therapy in delayed [[puberty]]. | * There are limited data about the cost-effectiveness of therapy in delayed [[puberty]]. | ||
* The main part of the economic burden of delayed [[puberty]] is because of | * The main part of the economic burden of delayed [[puberty]] is because of various non-specific and specific [[blood tests]], such as [[hormone]] assay. | ||
* The main treatment for the patients with [[short stature]] is [[Growth hormone|growth hormone (GH)]]. | * The main treatment for the patients with [[short stature]] is [[Growth hormone|growth hormone (GH)]]. | ||
=== Delayed puberty diagnostic laboratory tests === | === Delayed puberty diagnostic laboratory tests === | ||
* The brief definition of various [[hormone]] laboratory tests that | * The brief definition of various [[hormone]] laboratory tests that may be used for diagnosis of delayed [[puberty]] is presented here.<ref name="pmid10414639">{{cite journal |vauthors=Blondell RD, Foster MB, Dave KC |title=Disorders of puberty |journal=Am Fam Physician |volume=60 |issue=1 |pages=209–18, 223–4 |year=1999 |pmid=10414639 |doi= |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Laboratory test | !Laboratory test | ||
| Line 38: | Line 38: | ||
|$ 57 | |$ 57 | ||
|- | |- | ||
|Gonadotropin releasing hormone (GnRH) | |Gonadotropin-releasing hormone (GnRH) | ||
|$ 322 | |$ 322 | ||
|} | |} | ||
=== Growth hormone therapy === | === Growth hormone therapy === | ||
* General cost of [[GH]] treatment for every child (cost per child), the average height improvement in every child (growth per child), and measured cost of every | * General cost of [[GH]] treatment for every child (cost per child), the average height improvement in every child (growth per child), and measured cost of every inch the children have gained (cost per inches) are presented here.<ref name="LeeDavis2006">{{cite journal|last1=Lee|first1=Joyce M.|last2=Davis|first2=Matthew M.|last3=Clark|first3=Sarah J.|last4=Hofer|first4=Timothy P.|last5=Kemper|first5=Alex R.|title=Estimated Cost-effectiveness of Growth Hormone Therapy for Idiopathic Short Stature|journal=Archives of Pediatrics & Adolescent Medicine|volume=160|issue=3|year=2006|pages=263|issn=1072-4710|doi=10.1001/archpedi.160.3.263}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Group | !Group | ||
| Line 89: | Line 89: | ||
|- | |- | ||
| rowspan="3" |Dosing | | rowspan="3" |Dosing | ||
|Low dose (0.24 mg/kg/week) | |Low-dose (0.24 mg/kg/week) | ||
|$ 65,092 | |$ 65,092 | ||
|1.4 | |1.4 | ||
| Line 121: | Line 121: | ||
|$ 45,156 | |$ 45,156 | ||
|} | |} | ||
* General economic burden, consists of [[pharmacy]] costs, [[physician]] costs, and [[laboratory]] and [[Radiological|radiologic]] tests costs were measured as | * General economic burden, consists of [[pharmacy]] costs, [[physician]] costs, and [[laboratory]] and [[Radiological|radiologic]] tests costs were measured as follows: | ||
** [[GH]] cost per milligram, $52 | ** [[GH]] cost per milligram, $52 | ||
** Cost of [[physician]] visit, $58 | ** Cost of [[physician]] visit, $58 | ||
Latest revision as of 16:05, 3 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
There are limited data about the cost-effectiveness of therapy in delayed puberty. The main part of the economic burden of delayed puberty is because of various non-specific and specific blood tests, such as hormone assay. The main treatment for the patients with short stature is growth hormone (GH). The potential cost of treating all eligible children with growth hormone (GH) is approximately $40 billion dollars.
Cost-Effectiveness of Therapy
- There are limited data about the cost-effectiveness of therapy in delayed puberty.
- The main part of the economic burden of delayed puberty is because of various non-specific and specific blood tests, such as hormone assay.
- The main treatment for the patients with short stature is growth hormone (GH).
Delayed puberty diagnostic laboratory tests
- The brief definition of various hormone laboratory tests that may be used for diagnosis of delayed puberty is presented here.[1]
| Laboratory test | Cost (USD) |
|---|---|
| Follicle stimulating hormone (FSH) | $ 57 |
| Luteinizing hormone (LH) | $ 57 |
| Estradiol | $ 46 |
| Testosterone | $ 58 |
| Prolactin | $ 48 |
| Human gonadotropic hormone (hCG), beta sub-unit (quantitative) | $ 44 |
| Thyroid function tests (TSH, T4, T3, T3RU) | $ 57 |
| Gonadotropin-releasing hormone (GnRH) | $ 322 |
Growth hormone therapy
- General cost of GH treatment for every child (cost per child), the average height improvement in every child (growth per child), and measured cost of every inch the children have gained (cost per inches) are presented here.[2]
| Group | Variable | Cost per child
(USD) |
Growth per child
(in.) |
Cost per inches
(USD) |
|---|---|---|---|---|
| Efficacy | Lower (1.8 in) | $ 99,959 | 1.2 | $ 81,875 |
| Higher (3.9 in) | $ 99,959 | 2.6 | $ 38,783 | |
| Age at initiation | 8-13 years of age | $ 81,268 | 1.9 | $ 42,792 |
| 12-16 years of age | $ 126,123 | 1.9 | $ 66,411 | |
| Discontinuation rate | 0% | $ 137,779 | 2.6 | $ 53,531 |
| 40% | $ 87,352 | 1.7 | $ 52,174 | |
| Dosing | Low-dose (0.24 mg/kg/week) | $ 65,092 | 1.4 | $ 45,700 |
| Standard dose (0.37 mg/kg/week) for 2 years
then High dosage (0.7 mg/kg/week) at puberty for 3 years |
$ 155,440 | 3.1 | $ 49,821 | |
| Standard dose (0.37 mg/kg/week) for 1 years
then High dosage (0.7 mg/kg/week) at puberty for 4 years |
$ 170,866 | 3.4 | $ 50,384 | |
| Treatment duration | 7 years (age 8-15 years old) | $ 122,513 | 2.5 | $ 49,396 |
| 10 years (age 5-15 years old) | $ 145,550 | 3.2 | $ 45,156 |
- General economic burden, consists of pharmacy costs, physician costs, and laboratory and radiologic tests costs were measured as follows:
- GH cost per milligram, $52
- Cost of physician visit, $58
- Bone-age radiograph, $17
- Free thyroxine and thyrotropin measurement, $74
- Insulin-like growth factor I determination, $27.[2]
References
- ↑ Blondell RD, Foster MB, Dave KC (1999). "Disorders of puberty". Am Fam Physician. 60 (1): 209–18, 223–4. PMID 10414639.
- ↑ 2.0 2.1 Lee, Joyce M.; Davis, Matthew M.; Clark, Sarah J.; Hofer, Timothy P.; Kemper, Alex R. (2006). "Estimated Cost-effectiveness of Growth Hormone Therapy for Idiopathic Short Stature". Archives of Pediatrics & Adolescent Medicine. 160 (3): 263. doi:10.1001/archpedi.160.3.263. ISSN 1072-4710.