Cost-effectiveness of a connected injection device for daily somatropin therapy in pediatric growth hormone deficiency in Spain: a scenario-based microsimulation analysis using real-world data.

Aim: Growth hormone deficiency (GHD) in pediatric patients is characterized by impaired growth and reduced quality of life. Recombinant human growth hormone therapy requires consistent daily administration, yet adherence remains challenging. Electronic injection devices with adherence monitoring, like Easypod®, may support more consistent administration and enable more accurate assessment of treatment response. This study evaluated the cost-effectiveness of somatropin administered via a connected injection device (EasyPod) compared with nonconnected devices in pediatric patients with GHD in Spain. Materials & methods: A microsimulation model simulated 10,000 pediatric patients aged 2-13 years and incorporated adherence-dependent growth response, treatment discontinuation, costs and utilities. Outcomes included final height, height gain, cost per cm gained and incremental cost per quality-adjusted life year gained. Scenario and sensitivity analyses assessed the impact of parameter and structural uncertainty. Results: Easypod was associated with greater height gains than nonconnected devices. Projected final height at bone maturation was 163.04 cm with Easypod versus 159.21 cm with nonconnected devices, an incremental gain of 3.83 cm. Cost per cm gained was €2625 with Easypod and €3158 with nonconnected devices, a saving of €534 per cm. The incremental cost per quality-adjusted life year gained was €27,200 within Spain's willingness-to-pay threshold. Scenario and sensitivity analyses showed consistent results. Conclusion: In this model-based analysis, Easypod was associated with improved growth outcomes and was cost-effective compared with nonconnected devices in pediatric GHD patients in Spain. Continuous adherence monitoring may support treatment optimization and more efficient healthcare resource utilization.