Economic burden of growth hormone deficiency in a US pediatric population
| Autor: | Janna Manjelievskaia, Cynthia D Morrow, Pisit Pitukcheewanont, Paul Kaplowitz, Lorena Lopez-Gonzalez, Alden Smith |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Databases Factual Endocrinology Diabetes and Metabolism Pharmaceutical Science Pharmacy Disease Short stature Insurance Coverage Growth hormone deficiency Quality of life Pediatric Endocrinology Cost of Illness Health care Health insurance medicine Humans Child business.industry Human Growth Hormone Medicaid Health Policy Health Care Costs medicine.disease United States Child Preschool Growth Hormone Female medicine.symptom business Growth and Growth Hormone AcademicSubjects/MED00250 Pediatric population |
| Zdroj: | Journal of the Endocrine Society |
| ISSN: | 2376-1032 |
| Popis: | Pediatric GHD is a rare disorder of short stature that is currently treated with daily injections of GH. In addition to short stature, GHD is associated with other comorbidities such as impaired musculoskeletal development, cardiovascular disease, and decreased quality of life. The objective of this study was to analyze GH utilization, adherence, and healthcare costs among children with GHD who had either Medicaid or commercial health insurance. Children (age 65%) and followed for at least 3.7 years. Overall, 63.2% of Medicaid and 68.4% of commercial patients were treated with GH during follow-up. Among Medicaid patients, the treatment rate was highest among white males and lowest among black females. Adherence, as measured by proportion of days covered, was low, with 18.4% of Medicaid patients and 32.3% of commercial patients considered “adherent” (PDC ≥ 0.8). Nearly half (49.1%) of treated Medicaid patients and 24.3% of commercial patients discontinued GH therapy before age 13. After adjusting for baseline characteristics, all-cause non-GH costs were 5.7times higher (Δ$19,309) for Medicaid patients and 5.5 times higher (Δ$12,305) for commercial patients than matched non-GHD controls. Adjusted all-cause non-GH costs were 0.6 times lower (Δ$14,416) for treated Medicaid patients and 0.7 times lower (Δ$7,650) for treated commercial patients than for untreated patients. Pediatric GHD presents a significant healthcare burden, and many patients remain untreated or undertreated. Untreated GHD was associated with higher non-GH healthcare costs than treated GHD. Strategies to improve adherence may reduce the healthcare burden faced by these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|