OBJECTIVES: Response to GH therapy in children with IGHD can be further optimized. To evaluate the economic benefit of injecting GH with easypod®, an electronic auto injector that objectively monitors  drug administration, enabling differentiation of poor adherers from low responders. METHODS: A discrete event simulation model was developed to model continuous, intermittent (4 injections/week) and discontinued GH usage in children with IGHD until final height. A cohort of children (age: 4-12 years, growth delay: -4.0- -2.5 standard deviation scores [SDS] at baseline) was modeled to initiate GH (0.03mg/kg/day). Annual height gains of 1.2 to 0.8 SDS in year 1 were assumed to be 30% and 60% lower in each subsequent year of continuous and intermittent use, respectively. Baseline non-adherence was 9.3 persons per 100 person-years, of which 20% (1.86%) discontinued and the remainder used GH intermittently. A one-time identification of non-responders with GH dose increase of 50% was assumed after month 6 for children with low growth gains. The model was validated against final height gains observed in large international registries of children with IGHD. The rate of poor adherence was reduced by 10% and 30% in sensitivity analyses. Cost of GH was €32.80 per mg, and discounted at 3.5% per annum. RESULTS: The baseline cohort was modeled to achieve near final height SDS of -1.0 (±1.23) as observed in real-life registries, effectively gaining 16.0cm at a cost per cm gained of €3,929. Identification of low-responders increased height gain to 17.3cm at a cost per cm gained of €3987. Growth gains were maximized at 18.2cm at a cost per cm gained of €4073 when identifying low-responders and decreasing poor adherence by 30%. CONCLUSIONS: easypod® features can identify adherence profiles, allowing early recognition of low responders, giving the potential to optimise final height gain and investment in GH therapy in IGHD.