Developments in idiopathic short stature: cost versus allocation of resources

In the context of health-care costs, containment and economic downturn, there is a question as to whether the high cost of growth hormone (GH) therapy for patients with idiopathic short stature (ISS) is worth the health benefit provided. The economic evaluations of GH for the treatment of patients with ISS have considered gain in height as the major clinical endpoint. The incremental cost of each centimetre of adult height gained due to GH treatment has been estimated to be between £13,500 and £27,200 (€16,400 to €33,100), but could range from £4,300 to £272,000 (€5,200 to €330,900) depending on height gain, GH dose and unit cost, as well as discount rate chosen. Evidence regarding a potential benefit on health-related quality of life is lacking.