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Economic evaluation of a weekly administration of a sustained-release injection of recombinant human growth hormone for the treatment of children with growth hormone deficiency

Korean Journal of Pediatrics 2009;52(11):1249-1259.
Published online November 15, 2009.
Economic evaluation of a weekly administration of a sustained-release injection of recombinant human growth hormone for the treatment of children with growth hormone deficiency
Hye-Young Kang1, Duk Hee Kim2, Sei-Won Yang3, Yoon-Nam Kim4, Miseon Kim4
1Graduate School of Public Health, Institute of Health Services Research, Yonsei University
2Department of Pediatrics, Severance Children`s Hospital, Yonsei University
3Department of Pediatrics, College of Medicine, Seoul National University
4Graduate School of Public Health, Yonsei University
소아 성장호르몬결핍증 치료에 사용되는 성장호르몬 서방형 주사제의 경제성 평가
강혜영1, 김덕희2, 양세원3, 김윤남4, 김미선4
1연세대학교 보건대학원, 연세대학교 보건정책 및 관리 연구소
2연세대학교 세브란스 어린이병원 소아과
3서울대학교 의과대학 소아과교실
4연세대학교 보건대학원
Correspondence: 
Hye-Young Kang, Email: hykang@yuhs.ac
Abstract
Purpose
: From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency.
Methods
: Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered.
Results
: Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY.
Conclusion
: The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.
Key Words: Cost, Cost effectiveness, Growth hormone, Quality of life, Recombinant growth hormone, Utility


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