OBJECTIVES: Normalization of height in childhood and adolescence with growth hormone deficiency (GHD) is possible via the use of the recombinant human growth hormone somatotropin. Different injection techniques were developed including easypod™ device, prefilled pens (PP), and the regular subcutaneous syringe (SCS). The aim of this study is to determine whether injecting somatotropin using easypod™ device is a cost-effective treatment option in Egyptian children born with GHD.

METHODS: A Markov decision-tree model was used to calculate the relative costs and health benefits associated with each delivery technique over the treatment period (treatment with somatotropin 0.025 mg/kg/day from ages 5 to 13 years) for a number of simulated children born with GHD using patients charts records data. A wastage model was developed to include the difference in wastage among the various techniques. Estimates of patient height were derived from published literature, as was the proportion of patients achieving normal height through somatotropin treatment. Health care resources and drug costs associated with each of the treatment arms were considered, and cost-effectiveness was estimated as discounted (3.5% per annum) Egyptian pounds (EGP) per centimeter-height (cmH) gained.

RESULTS: Somatotropin delivery using easypod™ device was associated with an additional (5.15) cmH gained, at an incremental cost per cmH gained of (-13,021 EGP), compared with somatotropin PP. This means easypod™ device dominates. Versus delivery via SCS, easypod™ device resulted in additional (5.76) cmH gained at an incremental cost of (69,099 EGP). This equates to an incremental cost of (11,990 EGP) per cmH gained - below the widely accepted cost-effectiveness threshold in Egypt of (70,000 EGP).

CONCLUSIONS: In this model, somatotropin delivery using easypod™ device was a cost-saving option compared with somatropin PP, and a cost-effective one if compared with somatropin SCS. The use of somatropin easypod^™ device represents reasonable value for money for the treatment of GHD in Egyptian children.