INTRODUCTION

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Somatropin (Genotropin) (0.15 mg/day to 0.3 mg/day): Replacement of Endogenous Growth Hormone in Adults with Growth Hormone Deficiency [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Jan.

Cover of Somatropin (Genotropin) (0.15 mg/day to 0.3 mg/day)

Somatropin (Genotropin) (0.15 mg/day to 0.3 mg/day): Replacement of Endogenous Growth Hormone in Adults with Growth Hormone Deficiency [Internet].

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1INTRODUCTION

Somatropin (Genotropin) is an injectable recombinant human growth hormone indicated in Canada for the treatment of children who have growth failure due to an inadequate secretion of endogenous growth hormone (growth hormone deficiency; GHD), growth failure in short children born small for gestational age and who fail to achieve catch-up growth by two to four years or later, short stature associated with Turner syndrome in patients whose epiphyses are not closed, idiopathic short stature, and adults with GHD of adult- or childhood-onset. This Common Drug Review (CDR) pharmacoeconomic report will review its use in adults with GHD. The recommended dose of Genotropin in adults is 0.15 mg to 0.3 mg per day up to a maximum of 1.33 mg per day. The manufacturer submitted a confidential price of $▬ per milligram.

1.1. Cost Comparison Table

The comparator treatments presented in the table below have been deemed the appropriate comparators by clinical experts. Comparators may be recommended (appropriate) practice, versus actual practice. Comparators are not restricted to drugs, but may be devices or procedures. Costs are manufacturer list prices, unless otherwise specified.

Table 1Cost Comparison Table for Genotropin for Adult Growth Hormone Deficiency

Drug/ Comparator	Strength	Dosage Form	Price ($)	Recommended Dose	Average Daily Drug Cost^a ($)	Average Annual Drug Cost ($)
Genotropin^b	5.3 mg 12 mg	Pen	▬ ▬	Initial: 0.15 mg to 0.30 mg per day Max: 1.33 mg per day	Initial: ▬ – ▬ Max:▬	▬–▬ Max:▬
Genotropin^b	0.6 mg 0.8 mg 1.0 mg 1.2 mg 1.4 mg 1.6 mg 1.8 mg 2.0 mg	Syringe	▬ ▬ ▬ ▬ ▬ ▬ ▬ ▬		Max: ▬	Max: ▬
Humatrope	5 mg 24 mg	Vial	233.35 999.99	0.006 mg/kg to 0.0125 mg/kg per day titrated to adverse effects and to maintain IGF-1 less than upper limit for age and gender	21 to 49	7,665 to 17,886
Humatrope	6 mg 12 mg	Cartridge	280.02 560.04		24 to 49	8,585 to 17,886
Nutropin	10 mg	Vial	389.44	0.042 mg/kg to 0.175 mg/kg per week for patients younger than 35 years; maximum 0.0875 mg/kg per week for those older than 35 years	20 to 82	7,164 to 29,851
Nutropin AQ	10 mg	Cartridge	392.55		20 to 82	7,221 to 30,089
Drug/ Comparator	Strength	Dosage Form	Price ($)	Recommended Dose	Average Daily Drug Cost^a ($)	Average Annual Drug Cost ($)
Omnitrope	5 mg 10 mg	Vial	155.80 311.60	Initial: 0.15 mg to 0.30 mg per day Max: 1.33 mg per day	Initial: 5 to 9 Max: 41	Initial: 1,706 to 3,412 Max: 15,126
Saizen	3.33 mg 5 mg 8.8 mg	Vial	149.25 224.05 358.47	0.005 mg/kg to 0.01 mg/kg per day	17 to 38	6,245 to 13,742
Saizen	6 mg 12 mg 20 mg	Cartridge	268.83 537.66 896.10	0.005 mg/kg to 0.01 mg/kg per day	18 to 38	6,869 to 13,737

: IGF-1 = insulin-like growth factor-1.
: Prices are from the Saskatchewan Formulary (accessed August 23, 2013), unless otherwise indicated, and do not include dispensing fees.
a: Weight-based doses use the average adult weight of 84 kg reported by Kreitschmann-Andermahr et al. 2012.²
b: Manufacturer’s confidential submitted price.

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Somatropin (Genotropin) (0.15 mg/day to 0.3 mg/day): Replacement of Endogenous Growth Hormone in Adults with Growth Hormone Deficiency [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Jan. 1, INTRODUCTION.