Clinical effectiveness and cost-effectiveness of growth hormone in adults in relation to impact on quality of life: a systematic review and economic evaluation

Bryant J, Loveman E, Chase D, Mihaylova B, Cave C, Gerard K, Milne R
Record ID 32003001121
English
Authors' objectives:

This review considers the clinical effectiveness and cost-effectiveness of growth hormone (GH) therapy in adults with either adult-onset or childhood-onset growth hormone deficiency (GHD), using impact on quality of life (QoL) as the outcome measure.

Authors' results and conclusions: The evidence suggests that GH may improve QoL, although most change scores were modest and only a few were statistically significant. The interpretation of these change scores in terms of meaningfulness to patients is difficult. The analysis of the individual dimensions of the Nottingham Health Profile (NHP) from individual trials demonstrated statistically significant improvements in the GH replacement group, compared with the control group, for pain, emotional reactions and sleep. Meta-analysis showed a statistically significant difference in favour of GH on the NHP social isolation dimension.
Authors' recommendations: Fewer than half the adults with GHD are currently receiving GH therapy. Some may not be in clinical need; however, due to variation in prescribing policy, others who could potentially benefit are not being prescribed GH replacement therapy. Extending the use of GH to all those with severe GHD would have a budgetary impact. However, not all patients offered GH replacement therapy are likely to accept treatment. Trials of GH therapy in adults with GHD have not shown consistent benefit on QoL. GH may have beneficial effects on other factors (such as bone mineral density and cardiac function) that may indirectly affect QoL, but these factors were not examined in this review.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1271
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Costs and Cost Analysis
  • Growth Hormone
  • Growth Disorders
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.