Consequences of brand switches during the course of pediatric growth hormone treatment.

TitleConsequences of brand switches during the course of pediatric growth hormone treatment.
Publication TypeJournal Article
Year of Publication2012
AuthorsGrimberg A, Feudtner C, Gordon CM
JournalEndocr Pract
Volume18
Issue3
Pagination307-16
Date Published2012 May-Jun
ISSN1934-2403
KeywordsChild, Cost of Illness, Cost Savings, Drug Costs, Drug Utilization, Family, Formularies as Topic, Human Growth Hormone, Humans, Insurance, Pharmaceutical Services, Internet, Medication Adherence, Patient Education as Topic, Patient Satisfaction, Practice Patterns, Physicians', Recombinant Proteins, Surveys and Questionnaires, Time Factors, United States
Abstract

OBJECTIVE: To explore the effects of insurance-mandated brand switches during the course of pediatric recombinant human growth hormone (rhGH) treatment on clinical practice.

METHODS: We e-mailed a 9-question, anonymous, Internet-based survey to active members of the Pediatric Endocrine Society. The survey consisted of multiple-choice and yes/no answers. Free-text comments were solicited for further explanation of responses. Quantitative answers were tabulated. Each investigator independently coded the free-text responses; themes based on codes identified by all 3 investigators in a minimum of 5 different respondents' comments were compiled and organized.

RESULTS: Of the 812 active members of the Pediatric Endocrine Society who were e-mailed the survey, 231 responded. Two hundred eight respondents reported switching a patient's regimen from one rhGH product to another, and of these, 50% experienced repeated switches. Switches occurred for each commercially available rhGH brand. Frequent concerns noted by respondents involved dosing errors and treatment lapses from having to learn a new device and impaired adherence related to patient-family frustration and anxiety. Anti-GH antibodies, measured by only 3 endocrinologists when switching a patient's regimen from one brand to another, were negative before and after the product switch. When a patient switched rhGH brands, the most frequently reported time involvement for endocrine office staff was 2 hours for paperwork, 1 hour for device instruction, and 1 hour for "other" (mostly related to telephone reassurance).

CONCLUSION: GH brand switches may adversely affect patient care and burden pediatric endocrinology practices.

DOI10.4158/EP11217.OR
Alternate JournalEndocr Pract
PubMed ID21940275