Adults with growth hormone deficiency have higher medical costs, more comorbidities
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ATLANTA — Adults with growth hormone deficiency have higher health care costs and more comorbidities than those without growth hormone deficiency, according to findings presented at ENDO 2022.
“Analysis of claims data showed that growth hormone deficiency in adults has low treatment rates, four to five times higher medical costs and more than double the rate of disease-associated endocrine, metabolic, hepatic, renal and cardiovascular conditions than those seen in populations without growth hormone deficiency,” Alden Smith, PharmD, global head of health economics and outcomes research at Ascendis Pharma in Palo Alto, California, told Healio. “These are areas that require further study.”
Smith and colleagues conducted a retrospective observational cohort study of adults with data available in the IBM MarketScan Commercial Claims and Encounters Database and the MarketScan Medicaid Multi-State Database. Data was collected for adults aged 18 years and older diagnosed with growth hormone deficiency between Jan. 1, 2008, and Dec.31, 2017. Those with grown hormone deficiency were matched,1:3 with a control group of adults without growth hormone deficiency. Participants were followed from 12 months prior to the growth hormone deficiency diagnosis, or a random date for controls, until the end of the study on Dec. 31, 2018. Comorbidities and medications were collected for the 12-month pre-index period. Heath care costs, utilization and somatropin use were measured during follow-up.
There were 24,373 participants with commercial insurance and 2,579 Medicaid patients with growth hormone deficiency included in the study. They were matched to 73,119 commercial controls and 7,728 Medicaid controls.
More than 68% of adults with growth hormone deficiency had endocrine conditions compared less than 10% of controls. Metabolic conditions were observed in more than 93% of participants with growth hormone deficiency vs. less than 39% of controls, and renal function conditions were observed in 18% to 23% of the growth hormone deficiency cohorts compared with less than 10% of controls. Between 41% and 53% of those with growth hormone deficiency had cardiovascular disease vs. less than 29% of controls.
Mean annual all-cause health care costs were higher in adults with growth hormone deficiency compared with controls in both the Medicaid cohort ($42,309 vs. $9,146) and among commercial patients ($30,111 vs. $7,376). The increased costs were primarily driven by inpatient costs for adults with growth hormone deficiency in the Medicaid group and by outpatient costs for commercial patients with growth hormone deficiency.
Most adults with growth hormone deficiency did not receive somatropin therapy. The proportion of adults with growth hormone deficiency treated with somatropin was 9.5% in the Medicaid cohort and 5.8% in the commercial cohort.
“As discussions on the need to better diagnose and treat growth hormone deficiency in adults continue to evolve, this research reinforces the significant health and economic burden seen in this disease,” Smith said. “Further research is needed to gain insight into reasons for low treatment rates and to see if treatment can reduce the economic burden and improve the comorbidities that adults with growth hormone deficiency experience.”
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Smith A, et al. PMON64. Presented at: ENDO annual meeting; June 11-14; Atlanta (hybrid meeting).
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