Cost of Growth Hormone Therapy
Growth hormone therapy is expensive, with costs ranging from approximately $10,000 to $60,000 per year depending on dosage, patient characteristics, insurance coverage, and the specific formulation used. 1
Cost Factors in Growth Hormone Therapy
Growth hormone (GH) therapy costs are influenced by several key factors:
Dosage Requirements
- Standard dosing for children with chronic kidney disease: 0.045-0.05 mg/kg per day 1
- Dosage requirements vary based on:
- Patient weight (requiring regular dose adjustments)
- Indication for treatment
- Age of patient
- Response to therapy
Treatment Duration
- Typically long-term treatment (often years)
- For children with growth disorders: treatment continues until final adult height is reached
- For adults with GH deficiency: may be lifelong therapy 2
Formulation Types
- Daily injections (traditional formulation)
- Long-acting growth hormone (LAGH) preparations (newer options) 3
- Both have comparable efficacy and safety profiles
- Cost-effectiveness studies comparing these options are currently lacking
Cost-Benefit Considerations
Clinical guidelines specifically recommend considering the cost-benefit ratio before initiating growth hormone treatment in children with chronic kidney disease 1. This recommendation acknowledges the significant financial impact of therapy relative to expected outcomes.
For idiopathic short stature (ISS), a 2006 study estimated:
- Incremental cost of approximately $52,634 per inch of height gained
- Total cost of approximately $99,959 per child
- Average height gain of 1.9 inches (4.8 cm) 4
Insurance Coverage and Patient Costs
Patient out-of-pocket expenses vary significantly based on:
- Insurance type and coverage policies
- Whether coverage is through medical or pharmacy benefits
- Availability of patient assistance programs
- Treatment setting (hospital vs. outpatient clinic)
Higher patient out-of-pocket costs have been shown to be a barrier to initiating and adhering to recommended treatments 1. Clinicians should discuss with patients the potential for less expensive alternatives when available and comparable in terms of benefits and risks.
Cost Variation by Treatment Setting
Prices for growth hormone can vary substantially depending on:
- Group Purchasing Organization (GPO) pricing
- 340B program pricing (federal program for specific enrolled entities)
- Medicare pricing
- Commercial insurance reimbursement rates
Practical Considerations for Clinicians
When prescribing growth hormone therapy:
- Discuss financial implications with patients before initiating therapy
- Consider targeted treatment of patients with greatest potential for growth to maximize cost-effectiveness 4
- Investigate patient assistance programs from pharmaceutical manufacturers
- Verify insurance coverage and prior authorization requirements
- Monitor adherence, as cost may impact treatment compliance
Growth hormone therapy represents a significant financial investment, and the cost-benefit analysis should be carefully considered alongside clinical factors when making treatment decisions.