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 Costa ($) | Average Annual Drug Cost ($) |
|---|---|---|---|---|---|---|
| Genotropinb | 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:▬ |
| 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 |
| 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 ($) | Recommended Dose | Average Daily Drug Costa ($) | 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 |
| 6 mg 12 mg 20 mg | Cartridge | 268.83 537.66 896.10 | 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.
