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Healthcare utilization, quality of life and patient-reported outcomes during two years of GH replacement therapy in GH-deficient adults – comparison between Sweden, The Netherlands and Germany

Bernhard Saller, Anders F Mattsson¹, Peter H Kann^2,*, Hans P Koppeschaar^3,, Johan Svensson^4,, Marjolein Pompen^5, and Maria Koltowska-Häggström¹

Medical Department, Pfizer GmbH, Karlsruhe, Karlsruhe, Germany, ¹ KIGS/KIMS/ACROSTUDY Medical Outcomes, Pfizer Endocrine Care, Sollentuna, Sweden, ² Divison of Endocrinology & Diabetology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany, ³ Department of Endocrinology, University Medical Center Utrecht, Utrecht, Utrecht, The Netherlands, ⁴ Research Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Goteborg, Goteborg, Sweden, ⁵ Medical Department, Pfizer BV, Capelle a/d IJssel, Capelle a/d IJssel, The Netherlands

(Correspondence should be addressed to B Saller; EndoScience Endokrinologie Service GmbH, Thalkirchner Str. 1, 80337 Munich, Germany; Email: saller{at}endoscience.de)

Objective: This study set out to determine the change in quality of life (QoL) and healthcare utilization during 2 years of growth hormone (GH) replacement therapy in adults with GH deficiency. Data were compared from three European countries.

Design: Analysis was made from KIMS, the Pfizer International Metabolic Database on adult GH deficiency.

Methods: QoL and healthcare utilization were measured at baseline and after 1 and 2 years of GH replacement in patient cohorts from Sweden (n = 302), The Netherlands (n = 103) and Germany (n = 98). QoL was assessed by the QoL-Assessment in Growth Hormone Deficient Adults (QoL-AGHDA) questionnaire, and the KIMS Patient Life Situation Form was used to evaluate healthcare utilization.

Results: QoL improved significantly (P < 0.0001) and comparably in all three cohorts. The improvement was seen during the first year of treatment and QoL remained improved during the second year. The number of days in hospital was reduced by 83% (P < 0.0001) during GH replacement. There were no country-specific differences either at baseline or during follow-up. The same was true for the number of days of sick leave (reduction of 63%; P = 0.0004). Significant reductions were recorded in the number of doctor visits in each of the three cohorts after 2 years of GH replacement (P < 0.05).

Conclusions: This study provides a detailed comparative analysis of GH replacement therapy in GHD patients in three European countries. Despite some differences in treatment strategies, the beneficial effects on QoL, patient-reported outcomes and healthcare utilization are essentially similar in the healthcare environment of Western European countries.