A Descriptive Analysis of Patients Using Recombinant Human Growth Hormone (rhGH)—an Administrative Claims Database Study

Presentation Number: MON-0153
Date of Presentation: June 23rd, 2014

Michael Liang1, Chioma Smith*1, Wayne Weng1 and John Germak2
1Novo Nordisk Inc., Plainsboro, NJ, 2Novo Nordisk Inc, Plainsboro, NJ

Abstract

Introduction: There are 7 rhGH brands in the U.S., each containing the same active substance, somatropin(1-7). Brands differ by device type, dosing increments and attributes that may influence device usability. No known studies describe patient users of rhGH using an administrative claims database. The objective of this research  is to assess types of patients using rhGH and how patient characteristics impact product utilization. Methods: Retrospective analysis (2008-2012) using Truven Health Marketscan® databases.  Pediatric and adult patients with growth hormone (GH) deficiency and other GH-related disorders were included based on evidence of clinically validated ICD9 codes and use of Genotropin®, Humatrope®, Norditropin®, Nutropin®, Omnitrope®, Saizen® or Tev-Tropin®. Patients were naïve to and persistent with therapy (no fills of rhGH 1 year prior to diagnosis, last fill ≥1 year after first fill, no other rhGH used), with continuous enrollment ≥ 1 year before first diagnosis and after rhGH fill. Results: 1,144 patients met study criteria, 63% male. Majority of patients (77.7%) were diagnosed with GH deficiency, followed by idiopathic short stature (12.0%). Most patients were pediatric (≤18 yo; 81.4%) and across all rhGH, highest proportions of patients were of pubertal age (10-18 yo female; 11-18 yo male). Overall mean (SD)/median age was 17.9 yo (15.2)/13.0 yo. Mean (SD)/median pediatric age was 11.2 yo (3.3)/12.0 yo. Mean (SD)/median adult age was 47.5 yo (11.2)/49.0 yo. With exceptions of Genotropin® and Humatrope®, between 2009 and 2011, the highest proportions of initiators of rhGH were of pubertal age (PA), followed by child and adult. Adults represented the largest group of initiators for Genotropin® and Humatrope®. Total number of rhGH product initiators increased between 2009 and 2010 (228 vs. 482); the largest increase among PA initiators (106 to 261). Total initiators fell slightly in 2011 (434). From 2010 to 2011, number of adult initiators dropped by almost half (103 vs. 54, respectively). Conclusions: Findings support current, well-established knowledge in GH therapeutic area; most treated patients are male, ≤18 yo, diagnosed with GH deficiency. Further insight into changes in product initiators by year may reflect formulary changes and increasingly stringent policies on access and appropriate use, particularly for adults. Though the focus of this analysis was descriptive, future analyses including assessment of rhGH utilization patterns could further inform treatment practices in the GH disease area. Patient age group differences with product use (e.g., Genotropin®, Humatrope®) may play a role in product utilization, though further research is warranted.

 

Disclosure: ML: Employee, Novo Nordisk. CS: Researcher, Novo Nordisk. WW: Director, Medical Data Analytics, Novo Nordisk. JG: Senior Medical Director, Novo Nordisk.