Consequences of brand switches during the course of pediatric growth hormone treatment.
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<p><strong>OBJECTIVE: </strong>To explore the effects of insurance-mandated brand switches during the course of pediatric recombinant human growth hormone (rhGH) treatment on clinical practice.</p>
<p><strong>METHODS: </strong>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.</p>
<p><strong>RESULTS: </strong>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).</p>
<p><strong>CONCLUSION: </strong>GH brand switches may adversely affect patient care and burden pediatric endocrinology practices.</p>