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Pituitary diseases are relatively rare, but usually require lifelong management, often including a range of replacement therapies. Such chronic illnesses can be very traumatic for the patient and carers, involving, as they often do, changes to lifestyle, work capabilities and self-image, as well as issues of coping directly with the illness itself. Growth hormone deficiency (GHD) is one of the pituitary problems with which many of our patients struggle. Replacement therapy involves self-injection on a daily basis for life. There is a range of recombinant and biosimilar Growth Hormone (GH) therapies available and the key differences between them are the delivery device and the level of training and support available.

It has come to the attention of The Pituitary Foundation that some Primary Care Trusts are considering limiting the choices available of Growth Hormone products due to cost.  This would mean doctors would only be allowed to prescribe the least expensive brand of recombinant growth hormone, or a biosimilar growth hormone product. The Pituitary Foundation is fully supportive of all measures that aim to reduce the cost burden of healthcare, and accept that licensed therapies should be able to produce similar effects for our patient community. Nevertheless, concerns remain that need consideration on an individual patient basis. The devices that are used to deliver GH differ and many patients will have become accustomed to a specific device. In some circumstances this may make it harder for patients to switch to a different brand. In addition there are characteristics of some products that are unique, for example some are better for those patients less dexterous; some do not require refrigeration and this may be an essential consideration for some patients, especially those who travel frequently. The Pituitary Foundation strongly believes that such considerations need careful thought and discussion on an individual patient basis by any healthcare provider, and that for some patients switching to another preparation may not be a feasible proposition. In such cases the Pituitary Foundation advises that patients discuss carefully with their GP and Endocrinologist and seek representation from them if needed.

If you have concerns about this issue, please contact us on helpline@pituitary.org.uk.

21 October 2010

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