Endocrine Abstracts

JOINT385

Introduction: Suboptimal adherence to somatropin has negative effects on growth and has been observed in various populations. Patient support programs (PSPs) aim to improve treatment adherence and persistence. Since 2011, a PSP was implemented in Brazil to support all pediatric patients treated with Omnitrope^® (somatropin), offering nurse assistance, needle supply, instructional visits, thermal packaging, sharps collectors, WhatsApp messages, and educational materials.

Objectives: Evaluate enrollment rate, persistence, drop-outs, and patient satisfaction with the somatropin PSP in Brazil, identifying reasons for treatment discontinuation.

Methods: The database comprised all pediatric patients enrolled in the PSP from July 2011 to December 2024. Participants stopping Omnitrope^® treatment for any reason were discontinued from the PSP. Median persistence on program was calculated using Kaplan-Meier survival analysis (“event” being defined as participant leaving the program). From 2015 onwards, participants rated their satisfaction monthly using a 5-point Net Promoter Score (NPS).

Results: 24,136 participants (56% boys, 42% girls, 2% N/A) were enrolled in the Omnitrope^® PSP in Brazil. The average age at enrollment was 11.5 ±2.86 years. The median duration of participation in the program for the entire population was 57 months. There was no significant difference in persistence between boys and girls. Enrollment rates spiked during shortages of other somatropin products and in the first weeks of the COVID-19 pandemic. The average dropout rate has stabilized around 2% of active participants since 2015. The main reasons for discontinuation were treatment success (32% of discontinuing participants), lost to follow-up (32%), and switching to another somatropin product (15%). The NPS ranged between 4.6 and 4.8 points annually from 2015 to 2024.

Discussion: Strategies to improve treatment compliance and persistence in children with growth disorders are important. This analysis of a somatropin PSP with a large database revealed high median persistence on program and excellent rating of the provided services. This can be related to the unique Brazilian somatropin market, where only vial-based products are reimbursed, and other somatropin options (including Omnitrope^®) require out-of-pocket payment.

Conclusion: We analyzed the dynamics of a large somatropin PSP over 13 years. Patient enrollment was boosted by shortages of other somatropin products. The services provided by the PSP were highly appreciated by the patients and likely played a role in the observed high persistence in the program.