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Related Experiment Videos

Growth hormone coverage policy and implementation: a four-year experience.

H P Katz1

  • 1Harvard Pilgrim Health Care, Braintree, MA 02184, USA. katzh@warren.med.harvard.edu

HMO Practice
|May 7, 1997
PubMed
Summary

Implementing a growth hormone (GH) review policy significantly reduced costs and improved equitable access to GH treatment. This approach offers a model for managing high-cost pharmaceuticals and advanced technologies.

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Area of Science:

  • Health economics
  • Pharmaceutical policy
  • Endocrinology

Background:

  • Annual growth hormone (GH) expenditures in the US approach $400 million.
  • Controversy exists regarding GH treatment indications and insurance coverage.
  • Variability in GH access necessitates a structured policy approach.

Purpose of the Study:

  • To describe the 4-year experience of the Harvard Pilgrim Health Care (HPHC) Growth Hormone Review Committee.
  • To evaluate the impact of a policy limiting GH access to evidence-based indications.
  • To assess cost reductions and equity in GH treatment coverage decisions.

Main Methods:

  • Development of a policy and implementation plan in 1992 by HPHC.
  • Establishment of a Growth Hormone Review Committee for case-by-case review.
  • Analysis of prescribing costs and savings from 1992-1995.

Main Results:

  • Significant cost reductions, with estimated savings exceeding $1 million over 4 years.
  • Growth hormone prescribing costs decreased from 13.4% to 4.4% of total drug costs.
  • A more rational and equitable approach to GH treatment coverage decisions was achieved.

Conclusions:

  • The HPHC GH policy led to substantial cost savings and improved equity.
  • Caution is advised regarding expanded GH access due to potential side effects.
  • The policy framework may be applicable to managing other high-cost pharmaceuticals and technologies.

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