Background: Several somatropin products are available as pen and electronic devices. When administering the last dose from a device, patients may have an insufficient amount of GH remaining for a full dose.
Objective and hypotheses: The aim of this analysis was to estimate the potential GH waste per patient with pen devices and the easypod® device, and to quantify the potential economic impact of expected GH waste from patient and health care organization perspectives.
Method: A Waste Calculator Model was developed to examine GH waste. All somatropin products available in pen or electronic devices were included in the model. The user may define distribution across cartridges sizes (where applicable). The mechanical/priming loss applied to each product was based upon each products prescribing information and/or instructions for use. The base case model utilizes a US patient daily dose of 1.4 mg. The model assumes that the easypod® dose adjustment feature (±10, ±25, or ±50%) is activated by the clinician (base case model utilizes ±25%). Model assumes that 42.6% of caregivers will discard the remaining amount left in the cartridge (e.g. waste) if less than a full dose. Annual amount of GH waste (mg, cartridges, dollars) per patient and per population (based on US national market shares) for each pen/device is reported. Costs are based on USD 2013 wholesale acquisition cost (WAC) pricing, exclusive of discounts.
Results: The expected annual amount of waste per patient was lowest for easypod®. The expected annual amount of waste per patient was highest for Omnitrope®. The expected annual amount of waste ranged from 0 to 38.9 mg per patient per year, which is equal to 0 to 8 cartridges per patient per year and/or 0 to $2935 per patient per year. For a patient population of 100 GH-treated patients, the annual amount of waste is estimated at 2009 mg, which can be translated into approximately 342 cartridges or about $162 000 per year. There are several modifiable inputs to allow for examination of other scenarios. The results in GH waste fluctuated depending upon daily dose, cartridge size, and dose spread assumptions; however easypod® consistently had the lowest amount of expected annual waste.
Conclusion: The expected annual amount of GH waste evaluated in this Waste Calculator was lowest with easypod®. Cost of GH waste can be an important consideration when evaluating GH delivery devices.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology