Cost-effectiveness analysis of gonadotropin-releasing hormone analogue combined with recombinant human growth hormone in the treatment of central precocious puberty
- VernacularTitle:促性腺激素释放激素类似物联合重组人生长激素治疗中枢性性早熟的成本-效果分析
- Author:
Chunsong YANG
1
,
2
,
3
,
4
;
Jianing LIU
2
,
3
,
4
,
5
;
Zheng LIU
2
,
3
,
4
;
Linan ZENG
2
,
3
,
4
;
Jin WU
6
;
Lingli ZHANG
1
,
2
,
3
,
4
,
7
Author Information
1. Dept. of Pharmacy，West China Second Hospital，Sichuan University，Chengdu 610041，China
2. Evidence- based Pharmacy Center，West China Second Hospital，Sichuan University，Chengdu 610041，China
3. Key Laboratory of Correlation Technology of Pharmaceutical Preparations In Vitro and In Vivo，National Medical Products Administration，Chengdu 610041，China
4. Key Laboratory of Birth Defects and Related Diseases of Women and Children，Ministry of Education，Chengdu 610041，China
5. West China Clinical Medical College，Sichuan University，Chengdu 610041，China
6. Dept. of Pediatrics，West China Second Hospital，Sichuan University，Chengdu 610041，China
7. Molecular Translational Medicine Laboratory，Translational Medicine Center，Sichuan University，Chengdu 610041，China
- Publication Type:Journal Article
- Keywords:
central precocious puberty;
gonadotropin-releasing hormone analogue;
recombinant human growth hormone
- From:
China Pharmacy
2025;36(1):79-85
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To compare the long-term cost-effectiveness of gonadotrophin-releasing hormone analogue （GnRHa） combined with recombinant human growth hormone （rhGH） （combination therapy regimen） versus GnRHa monotherapy （monotherapy regimen） in the treatment of central precocious puberty （CPP）. METHODS From the societal perspective and based on a real-world study conducted at West China Second Hospital of Sichuan University， the cost-effectiveness analysis was performed to compare the long-term cost-effectiveness of two pharmacotherapy regimens for CPP girls， with final height as outcome indexes， using per capita disposable income of rural residents and urban residents （20 133-49 283 yuan） in 2022 as the social willing-to-pay （WTP） threshold. The robustness of the basic analysis result was verified by using one-way sensitivity analysis and probability sensitivity analysis， and the cost-effectiveness of different combinations of long-acting preparations was compared using scenario analysis. RESULTS The basic analysis result showed that the combination therapy regimen required an additional cost of 25 193.49 yuan for every one-centimeter improvement in the final height of girls with CPP compared with the monotherapy regimen， which was not cost-effective for residents in rural areas， but it was cost-effective for residents in urban areas. One-way sensitivity analysis showed that the uncertain factors with potential impacts on the results were， in order， the price of rhGH， the final height of pediatric patients in the combination therapy regimen group， the course of rhGH in the combination therapy regimen group， and the final height of pediatric patients in the monotherapy regimen group. Probabilistic sensitivity analysis indicated that the probability of the combination therapy regimen being cost-effective was higher than that of the monotherapy regimen when WTP was more than 26 010 yuan/cm. When GnRHa long-acting preparation was used for intramuscular injection every 3 months， the combination therapy regimen was not cost-effective for rural residents， but was cost-effective for urban residents； when rhGH long-acting preparation was injected subcutaneously once a week， the combination therapy regimen was not cost-effective for residents in both rural areas and urban areas. CONCLUSIONS The combination of GnRHa and rhGH is only recommended for CPP children with better affordability to improve final height. The benefits， risks， and affordability of treatment should be comprehensively considered before the decisions on pharmacotherapy， to avoid abuse of rhGH due to the blind pursuit of height growth.
