Growth hormone use in transitioning patients - Clinician and payer concerns

Determining which patients with childhood-onset growth hormone (GH) deficie ncy will require continuing GH therapy into and/or throughout adulthood rai ses clinical and economic issues, such as retesting, appropriate dosing, an d the risks and benefits of uninterrupted GPI treatment versus the disconti nuation of therapy. In his review of the evaluation and management of patients transitioning fr om GH therapy in childhood to GH therapy in adulthood, Dr. Stephen LaFranch i focuses on the odds of having ongoing GH deficiency, the changes that occ ur when therapy is discontinued, appropriate follow up of patients who disc ontinue treatment, and issues regarding the reinitiation of therapy. Dr. Ma rgaret H. MacGillivray addresses appropriate monitoring and follow up of pa tients in transition, as well as their classification by etiology and sever ity of GH deficiency. Dr. Pete Fullerton explores new issues regarding GN d eficiency treatment from a managed care perspective.