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SaizenPoint32Health

Growth Hormone Deficiency due to Lack of Endogenous Secretion

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 failed response to one (1) standard growth hormone stimulation test (peak GH < 10 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
  • Documentation patient’s epiphyses are open confirmed by radiograph of the wrist and hand
  • Documentation of therapeutic response defined as growth velocity ≥ 2 cm compared with previous year

Approval duration

12 months