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An auxology-based growth hormone program: update on the Australian experience
George A Werther1, Mei Wang, Christopher T Cowell
1Centre for Hormone Research, Department of Endocrinology and Diabetes, Royal Children's Hospital, Parkville, Victoria, Australia. werther@cryptic.rch.unimelb.edu.au
Journal of Pediatric Endocrinology & Metabolism : JPEM
|June 11, 2003
Summary
Australian guidelines for growth hormone (GH) therapy, emphasizing auxological criteria, ensure effective and economical treatment for short children. Stricter criteria in 1993-94 halved patient numbers and costs, maintaining treatment quality.
Area of Science:
- Pediatrics
- Endocrinology
- Growth Disorders
Background:
- New guidelines for growth hormone (GH) usage based on auxological criteria were implemented in Australia in 1988.
- A significant number of children are treated for various conditions including idiopathic GH deficiency, malignancy-related GHD, Turner's syndrome, and idiopathic short stature.
Purpose of the Study:
- To evaluate the outcomes of growth hormone therapy in children using auxology-based criteria in Australia.
- To assess the impact of revised entry and exit criteria on patient numbers, expenditure, and treatment effectiveness.
Main Methods:
- Analysis of patient data including diagnoses, age at therapy onset, GH doses, and final height outcomes.
- Comparison of treatment outcomes across different diagnostic groups.
- Evaluation of changes in patient numbers and healthcare expenditure following the introduction of stricter criteria in 1993-94.
Main Results:
- Children with GH deficiency showed the best final height outcomes, with significant height improvement (2.0 SDS).
- GH doses varied by diagnosis, with Turner's syndrome patients receiving the highest doses.
- Implementation of stricter criteria in 1993-94 led to a halving of patient numbers and expenditure, with costs stabilizing around US dollars 9-10 million annually.
Conclusions:
- Auxology-based criteria facilitate rational, effective, and economical growth hormone therapy for short children in Australia.
- The revised criteria successfully controlled patient numbers and costs while maintaining treatment efficacy.