 | Highlight on Drugs | | |
Debating The Use Of Growth Hormone In Healthy But Short Children
June 20, 2003
Last reviewed and revised by Faculty of Harvard Medical School on Dec. 17, 2006  By Howard J. DeMonaco, M.S.
Massachusetts General Hospital Synthetic growth hormone is manufactured by several companies and is used as a replacement therapy for children who have a deficiency of the hormone. Short stature is a social handicap. Income level and opportunity for career advancement seem to be impacted by height. People of both genders who are well below average in height appear to be the victims of subtle discrimination. But is short stature a medical condition that needs with drug therapy? Are the risks of the drug offset by the benefit of the increased height? Parents will need to weigh the risks of the drug and the benefit of increasing the adult height in their children. Synthetic growth hormone must be given by injection. Studies have shown that by giving the drug three times a week to short children over a four- to five-year period, they gained about 1½ to 2 inches in height. Synthetic growth hormone is expensive, with costs as high as $20,000 a year during the child's growth years. The cost works out to about twice that for every inch of growth. There is also a risk of drug side effects. In addition to the pain of injection three times a week for four to five years, people getting synthetic growth hormone can also experience edema (water buildup in tissues), headache, nausea, vomiting and muscle pain. Interestingly, children treated with synthetic growth hormone also seem to suffer from more ear infections and other ear problems. The U.S. Food and Drug Administration limit the use of the synthetic growth hormone to boys who are likely to be shorter than 5-feet 3-inches and to girls likely to grow to be shorter than 4-feet 11-inches. Based on what we know at the moment, the use of synthetic growth hormone will allow boys and girls to reach adult heights of up to 5-feet 6-inches in the boys and 5 feet 1 inches respectively./p> Is there a need for this kind of therapy? If so, who should pay for it? The FDA looked at the risks and benefits and decided the drug side effects are worth the added height gained. Society is going to have to decide how much it is willing to pay for the added inches. At the moment, some, but not all, insurance companies will pay for growth hormone for use in otherwise healthy but short children. Harold J. DeMonaco, M.S. is senior clinical associate in the Decision Support and Quality Management Unit at the Massachusetts General Hospital and is currently a Visiting Scholar at the MIT Sloan School of Management. He is author of over 20 publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals.
| 
