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The Burden of Illness of Hypopituitary Adults with Growth Hormone Deficiency

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Abstract

Objective: The negative metabolic and psychosocial consequences of growth hormone deficiency (GHD) in adults are now well established. In the present study, an attempt was made to quantify the burden of illness, in terms of lost productivity and increased medical consumption, associated with hypopituitarism and untreated GHD.

Design and Setting: The study population consisted of 129 Belgian adults with untreated GHD associated with hypopituitarism after pituitary surgery. The Short-Form 36 Health Survey (SF-36) was used to assess health status, and the Health and Labour Questionnaire was used to measure production losses and labour performance. Data on medical consumption were also collected.

Main Outcome Measures and Results: Hypopituitary patients reported a lower health status than that of the general population in all but two dimensions of the SF-36 (pain and physical functioning). Nearly 11% of the patients reported being incapacitated for paid employment due to health problems, compared with 4.8% of the general Belgian population. Patients in paid employment reported a mean of 19.8 days of sickness leave per year, which is twice that in the general population. The annual number of visits to general practitioners and specialists was also higher in the patients (9.6 and 6.5 visits, respectively, for the patients compared with corresponding figures of 2.1 and 1.5 for the general Belgian population). The average annual number of days spent in hospital was 3.5 for the patients compared with 2.3 in the general population. The annual healthcare costs and costs due to production losses calculated for hypopituitary patients who had received pituitary surgery amounted to 135 024 Belgian francs (BeF) or $US4340 (1995 values). This compares with the mean annual cost per person for the Belgian population as a whole of BeF68 569 or $US2204.

Conclusions: Hypopituitary patients with untreated GHD therefore have a higher cost to society in terms of lost production and medical consumption than the average Belgian population.

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References

  1. Cuneo RC, Salomon F, Wiles CM, et al. Growth hormone treatmentin growth hormone deficient adults. II: effect on exerciseperformance. J Appl Physiol 1991; 70: 695–700

    PubMed  CAS  Google Scholar 

  2. Markussis V, Beshyah SA, Fisher C, et al. Detection of prematureatherosclerosis by high-resolution ultrasonography in symptom-free hypopituitary adults. Lancet 1992; 340: 1188–92

    Article  PubMed  CAS  Google Scholar 

  3. Amato G, Carella C, Fazio S, et al. Body composition, bonemetabolism and heart structure and function in growth hormone(GH)-deficient adults before and after GH-replacementtherapy at low doses. J Clin Endocrinol Metab 1993; 77:1671–6

    Article  PubMed  CAS  Google Scholar 

  4. Rosén T, Edén S, Larson G, et al. Cadiovascular risk factors inadult patients with growth hormone deficiency. Acta Endocrinol(Copenh) 1993; 129: 195–200

    Google Scholar 

  5. Johansson J-O, Landin K, Tengborn L, et al. High fibrinogenand plasminogen activator inhibitor activity in growth hormonedeficient adults. Arterioscler Thromb 1994; 14: 434–7

    Article  PubMed  CAS  Google Scholar 

  6. Kaufman J-M, Taelman P, Vermeulen A, et al. Bone mineralstatus in growth hormone-deficient males with isolated and multiple pituitary deficiencies of childhood onset. J Clin Endocrinol Metab 1992; 74: 118–23

    Article  PubMed  CAS  Google Scholar 

  7. Rosén T, Hansson T, Granhed H, et al. Reduced bone mineralcontent in adult patients with growth hormone deficiency.Acta Endocrinol (Copenh) 1993; 129: 201–6

    Google Scholar 

  8. Salomon F, Cuneo RC, Hesp R, et al. The effects of treatmentwith recombinant human growth hormone on body compositionand metabolism in adults with growth hormone deficiency.N Engl J Med 1989; 321: 1797–803

    Article  PubMed  CAS  Google Scholar 

  9. Rosén T, Boseaus I, Tölli J, et al. Increased body fat mass anddecreased extracellular fluid volume in adults with growthhormone deficiency. Clin Endocrinol (Oxf) 1993; 38: 63–71

    Article  Google Scholar 

  10. McGauley GA.Quality of life assessment before and aftergrowth hormone treatment in adults with growth hormonedeficiency. Acta Paediatr Scand Suppl 1989; 356: 70–2

    Article  PubMed  CAS  Google Scholar 

  11. Rosén T, Wirén L, Wilhelmsen L, et al. Decreased psychologicalwell-being in adult patients with growth hormone deficiency.Clin Endocrinol (Oxf) 1994; 40: 111–6

    Article  Google Scholar 

  12. Ware Jr JE, Sherbourne CD. The MOS 36-Item Short-FormHealth Survey (SF-36). Med Care 1992; 30(6): 473–81

    Article  PubMed  Google Scholar 

  13. van Roijen L, Essink-Bot ML, Koopmanschap MA, et al. Labourand health status in economic evaluation of health care.Int J Technol Assess Health Care 1996; 12: 405–15

    Article  PubMed  Google Scholar 

  14. Ware JE, Snow KK, Kosinski M, et al. SF-36 Health Survey:manual and interpretation guide. Boston: Nimrod Press, 1993

    Google Scholar 

  15. Drummond MF. Cost of illness study: a major headache? Pharmacoeconomics1992; 2(1): 1–4

    Article  PubMed  CAS  Google Scholar 

  16. Lindgren B. Costs of illness in Sweden 1964-1975. Lund: Liber,1981

  17. Koopmanschap MA, Rutten FFH, van Ineveld BM, et al. Thefriction cost method for measuring indirect costs of disease.J Health Econ 1995; 14: 171–89

    Article  PubMed  CAS  Google Scholar 

  18. Lombaert G, de Graeve D, Hermann I, et al. Costs of absencefrom work on company level [in Dutch]. Econ Soc Tijdschrift 1996; 50(3): 459–81

    Google Scholar 

  19. Rijksinstituut voor Ziekte en Invaliditeitsverzekering (RIZIV).Data on the number of incapacitated persons for Belgium in1993. Brussels: RIZIV, 1996

  20. Statute book, tariffs on hospital days, specialists and GP visits.Brussels: The National Mutual Healthcare Services, 1995

  21. National Data-Base on Health Statistics (ARIS). Data on healthservice use for Belgium in 1992: health information package of the Centre for Health Economics and Hospital Policy.Brussels: Center for Health Economics and Hospital Management(VUB/UCL), 1996

  22. Data on file. Department of Social Affairs, Health and Environment.Data on the number of hospital days in Belgium hospitalsfor 1992.

  23. Rijksinstituut voor Ziekte en Invaliditeitsverzekering (RIZIV).Data on the number of visits to specialist and general practitionersfor Belgium in 1992. Brussels: RIZIV, 1996

  24. van der Zee KI, Sanderman R. Measuring general health statususing the Rand-36 [in Dutch]. Groningen: Northern Centerfor Health Problems, 1993

    Google Scholar 

  25. Nationaal Instituut voor de Statistiek (NIS). Sociale statistieken:enquête naar de beroepsbevolking, 1995. Brussels: NIS, 1995

  26. Central Planning Bureau (CPB). Uncertainties on labour timereduction in the medium term [in Dutch]. The Hague: CPB,1987. Working document no.: 14

  27. Koning J, Tuyl FAWM.The relation between labour time, productionand employment [in Dutch]. Rotterdam: Netherlands Economic Institute, 1984

    Google Scholar 

  28. Shiell A, Gerard K, Donaldson C. Cost of illness studies: an aidto decisionmaking?. Health Policy 1987; 8: 317–23

    Article  Google Scholar 

  29. Hodgson TA. Cost of illness studies: no aid to decision making?Health Policy 1989; 11: 57–60

    Article  PubMed  CAS  Google Scholar 

  30. Ware JE, Keller SD, Gandek B. Evaluating translations ofhealth status questionnaires. Int J Technol Assess Health Care1995; 11(3): 525–51

    Article  PubMed  Google Scholar 

  31. Verhelst J, Abs R, Vandeweghe M, et al. Two years of replacementtherapy in 148 adults with growth hormone deficiency.Clin Endocrinol (Oxf) 1997; 47(4): 485–94

    Article  CAS  Google Scholar 

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Correspondence to Leona Hakkaart-van Roijen.

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Roijen, L.Hv., Beckers, A., Stevenaert, A. et al. The Burden of Illness of Hypopituitary Adults with Growth Hormone Deficiency. Pharmacoeconomics 14, 395–403 (1998). https://doi.org/10.2165/00019053-199814040-00006

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