Cost-effectiveness of a connected injection device for daily somatropin therapy in pediatric growth hormone deficiency in Spain: a scenario-based microsimulation analysis using real-world data.
Easypod may provide greater height gains and cost savings compared to nonconnected devices for pediatric patients with growth hormone deficiency, but results are based on a model and may not reflect all real-world factors.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This study evaluated the cost-effectiveness of somatropin administered via a connected injection device (Easypod) compared with nonconnected devices in pediatric patients with growth hormone deficiency (GHD) in Spain. The analysis simulated 10,000 pediatric patients aged 2-13 years. Easypod was associated with greater height gains and lower costs per cm gained.
Abstract
Aim: Growth hormone deficiency (GHD) in pediatric patients is characterized by impaired growth and reduced quality of life. Recombinant human growth hormone therapy requires consistent daily administration, yet adherence remains challenging. Electronic injection devices with adherence monitoring, like Easypod®, may support more consistent administration and enable more accurate assessment of treatment response. This study evaluated the cost-effectiveness of somatropin administered via a connected injection device (EasyPod) compared with nonconnected devices in pediatric patients with GHD in Spain. Materials & methods: A microsimulation model simulated 10,000 pediatric patients aged 2-13 years and incorporated adherence-dependent growth response, treatment discontinuation, costs and utilities. Outcomes included final height, height gain, cost per cm gained and incremental cost per quality-adjusted life year gained. Scenario and sensitivity analyses assessed the impact of parameter and structural uncertainty. Results: Easypod was associated with greater height gains than nonconnected devices. Projected final height at bone maturation was 163.04 cm with Easypod versus 159.21 cm with nonconnected devices, an incremental gain of 3.83 cm. Cost per cm gained was €2625 with Easypod and €3158 with nonconnected devices, a saving of €534 per cm. The incremental cost per quality-adjusted life year gained was €27,200 within Spain's willingness-to-pay threshold. Scenario and sensitivity analyses showed consistent results. Conclusion: In this model-based analysis, Easypod was associated with improved growth outcomes and was cost-effective compared with nonconnected devices in pediatric GHD patients in Spain. Continuous adherence monitoring may support treatment optimization and more efficient healthcare resource utilization.
Background
This paper addresses the challenge of adherence to recombinant human growth hormone therapy in pediatric patients with growth hormone deficiency (GHD). Previous studies have shown that consistent administration is crucial for optimal growth outcomes. This study is significant as it evaluates a connected injection device's potential to improve adherence and treatment response in this population.
Methods
A microsimulation model was used to simulate 10,000 pediatric patients aged 2-13 years. The analysis incorporated adherence-dependent growth response, treatment discontinuation, costs, and utilities. Primary outcomes included final height, height gain, cost per cm gained, and incremental cost per quality-adjusted life year gained.
Results
The primary endpoint showed that Easypod was associated with a projected final height of 163.04 cm, compared to 159.21 cm for nonconnected devices, resulting in an incremental height gain of 3.83 cm. The cost per cm gained was €2625 for Easypod versus €3158 for nonconnected devices. The incremental cost per quality-adjusted life year gained was €27,200.
Interpretation
The findings suggest that while Easypod may lead to statistically significant improvements in height gain, the clinical significance of a 3.83 cm increase should be considered in the context of individual patient needs. The study's reliance on a microsimulation model introduces uncertainties, and the results may not be applicable to all healthcare settings. Practitioners should weigh these factors when considering the adoption of connected devices in clinical practice.
Key findings
- Projected final height at bone maturation was 163.04 cm with Easypod versus 159.21 cm with nonconnected devices, an incremental gain of 3.83 cm.
- Cost per cm gained was €2625 with Easypod and €3158 with nonconnected devices, a saving of €534 per cm.
- The incremental cost per quality-adjusted life year gained was €27,200 within Spain's willingness-to-pay threshold.
Limitations
- Based on a microsimulation model, not direct clinical trial data.
- Results may not be generalizable outside of Spain.
- No long-term follow-up data reported.