OBJECTIVES::  The treatment of growth hormone deficiency and Turner syndrome recommended in the Brazilian public health system (SUS) foresees the use of somatropin (4 and 12 IU) in pediatric and adult patients. The objective of the study was to analyze and compare the costs, waste and effects of adherence to the treatment of somatropin presentations made available in SUS in relation to other presentations of the drug registered in Brazil, but not reimbursed. METHODS::  A cost-minimization and budgetary impact analysis was developed, from a SUS perspective, for pediatric patients receiving somatropin. The reimbursement was set at R$ 3.53 per UI. For calculation of waste, the stability of each presentation was considered, as well as the disposal of the residual amount of medicine if this was not sufficient for a complete dose. The budgetary impact took into account the number of patients undergoing treatment in SUS, in these indications, as well as data from the literature regarding adherence to treatment, both with needle and syringe or with pens and electronic devices. RESULTS:: The average annual treatment cost per patient is R$ 2,763.96. Using 4UI presentation, annual wastage reaches R$ 2,319.24 added to the treatment cost. Considering the substitution of somatropin 4UI and 12UI, which don’t have device, by somatropin 36UI and 60UI, which have electronic device, the proposed budgetary impact would provide savings of R$ 12,929,198.63 (or 4,677 additional patients). When taken into account wastage and adherence, the proposed scenario brings savings of R$ 22,449,352.22 (or inclusion of 8,122 patients). CONCLUSIONS:: The present analysis shows the importance to reduce wastage, as well as increasing adherence to treatment, and their influence on the budgetary impact. Cost-minimization suggests that the choice of drugs that have devices, mainly digital devices, results in great resource savings by not generating waste and increasing adherence to treatment.