Evaluation of Potential Waste of Growth Hormone Across Available Pen Devices and an Electronic Delivery Device in the United States 

Presentation Number: SUN 287
Date of Presentation: April 2nd, 2017

Duncan Brown*1, Julie C Locklear2 and Alena Zalutskaya2
1Xcenda, 2Merck Serono, Rockland, MA


Background and Rationale:

In the United States, the cost of all wasted medications was estimated to total up to $117B a year (1). Faced with financial challenges in healthcare, it is valuable to examine methods of minimizing drug wastage while improving patient care. Growth hormone (GH) is an expensive medication, which is used in treatment of patients with GH deficiency. The aims of this analysis were to estimate the potential GH waste per patient with GH deficiency with Pen devices and the easypod®device, and to quantify the potential economic impact of GH waste from the perspectives of a patient and health care organization in the United States.


Materials and Methods:

An interactive model was developed to estimate the expected waste generated with available GH Pen devices (Nutropin® AQ NUSPIN, Humatrope®, Genotropin®, Norditropin®, Omnitrope™ and Zomacton™) and the electronic delivery device easypod® in pediatric patients with GH deficiency. Expected drug waste per cartridge was based upon survey data (2) for the proportion of caregivers who discard any remaining partial dose after administration of GH. Mechanical drug loss was assumed to be 10% across all GH Pen devices in this tool. Costs for each GH brand were obtained from Redbook (3). The model calculated the cost of GH waste per cartridge, annual cost of waste per patient (2016 dollars), total annual waste per patient (mg), days of GH treatment wasted per year, and cost of drug waste per patient over five years. A health plan level analysis was also conducted by using internal market share data.


We included into the analysis 100 pediatric patients with GH deficiency. The expected annual cost of GH waste per patient was lowest for easypod® ($96.85), while for Pen devices GH waste cost ranged from $257.60 (Omnitrope™) to $2,235.03 (Genotropin®). The average annual GH waste cost across all devices was $1,132.57 per patient, with the average annual drug waste of 13.1 mg per patient. Over a 5-year time period, the total cost of GH wastage for the health plan was predicted to be $465,233.50. Sensitivity analysis showed that, compared with the Pen devices, easypod®resulted in less GH waste in the majority of scenarios tested. Results were sensitive to daily dose, cartridge size, and dose-spread assumptions.


The expected annual amount of GH waste was lowest with easypod® in most scenarios compared to GH Pen devices. Pharmacy-related drug waste represents a costly burden to the healthcare system; the use of devices that minimize GH waste may result in reductions in pharmacy-related healthcare spending, benefiting patients and the health system.


Disclosure: JCL: Employee, Merck & Co.. AZ: Employee, Merck & Co.. Nothing to Disclose: DB