title: Indications for recombinant human growth hormone and evaluation of available recombinant human growth hormone devices: implications for managed care organizations.
abstract: There are now many recombinant human growth hormone (rhGH) products and delivery devices available for rhGH therapy. Not all products are approved to treat both children and adults, and they vary with respect to indications approved by the US Food and Drug Administration. Dosing of rhGH is based on weight, and a higher dose (per kg) is recommended in children than adults. This approximates the normal difference in growth hormone (GH) secretion between these 2 patient populations. Patient adherence to treatment is influenced by a number of factors, and patient inclusion in treatment decisions, such as the choice of delivery device, appears to be important. Unmet expectations are a key issue for many patients and families who decide to discontinue treatment. Counseling patients and families about predicted adult height with rhGH therapy should be based on realistic expectations. Managed care organizations face several challenges in providing rhGH therapy, including deciding who is most likely to benefit from treatment and when to discontinue treatment if the benefits appear to level off.
authors.affiliation: SelectHealth, Inc, Salt Lake City, Utah, USA. jeffrey.dunn@selecthealth.org
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dunn
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Nickman
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D016503:Drug Delivery Systems / Q000295:instrumentation*; D006130:Growth Disorders / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D014481:United States
chemical_list: D019382:Human Growth Hormone