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SaizenPoint32Health

Childhood Onset Growth Hormone Deficiency

Preferred products

  • Omnitrope

Initial criteria

  • Patient age ≥ 18 years
  • Documented diagnosis of one (1) of the listed conditions
  • Documentation of one (1) of the following: pituitary gland removed OR multiple other pituitary hormone deficiencies due to organic disease or congenital/genetic growth hormone deficiency OR failed response to one (1) standard growth hormone stimulation test (peak GH < 5 ng/mL)
  • Prescribed by or in consultation with an endocrinologist

Reauthorization criteria

  • Patient age ≥ 18 years
  • Documented diagnosis of one (1) of the listed conditions
  • Prescribed by or in consultation with an endocrinologist

Approval duration

12 months