[Social medicine aspects of growth hormone treatment of children].
A growing number of innovative, high-cost drugs call for assessment from social medicine. Synthetic human growth hormone (somatropin, STH) is a prominent example. The use of STH in children greatly increased over the last few years. Treatment extends over years and cost may add up to 30,000 to 70,000 DM/year. STH is licensed for treatment of insufficient secretion of growth hormone, in girls with Ullrich Turner Syndrome and in prepubertal children with chronic renal failure. Off-label use of STH is widespread. The following questions arise: Is STH treatment medically necessary? Must social security (health insurance) carriers pay for STH treatment? Which methods are appropriate to analyse growth and to ascertain growth hormone deficiency? The stated target of STH treatment is a relevant increase of body height. Is this target achieved in the various indications? Special problems arise where psychosocial considerations are put forward.
Kreck
C
C
MDK in Hessen.
Bingel
S
S
Heberlein
E
E
Schepping
M
M
Winkler
U
U
D000293:Adolescent; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D017277:Drug Approval / Q000331:legislation & jurisprudence*; D004393:Dwarfism, Pituitary / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005858:Germany; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000331:legislation & jurisprudence; D008297:Male; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D011994:Recombinant Proteins; D019382:Human Growth Hormone