Growth hormone use in transitioning patients--clinician and payer concerns

Determining which patients with childhood-onset growth hormone (GH) deficiency will require continuing GH therapy into and/or throughout adulthood raises clinical and economic issues, such as retesting, appropriate dosing, and the risks and benefits of uninterrupted GH treatment versus the discontinuation of therapy. In his review of the evaluation and management of patients transitioning from GH therapy in childhood to GH therapy in adulthood, Dr. Stephen LaFranchi focuses on the odds of having ongoing GH deficiency, the changes that occur when therapy is discontinued, appropriate follow up of patients who discontinue treatment, and issues regarding the reinitiation of therapy. Dr. Margaret H. MacGillivray addresses appropriate monitoring and follow up of patients in transition, as well as their classification by etiology and severity of GH deficiency. Dr. Pete Fullerton explores new issues regarding GH deficiency treatment from a managed care perspective.