Tag Archives | Human Growth Hormone

Big Pharma

Another post from the archives (I’ve got biiig archives…wanna come over and see them sometime?).  This post is from 2010, when we first started Liam on HGH. He’s been doing these shots now for three years, more or less, and still hates them.  But he’s growing. The doctor told us, back in April of 2010 “that if we lived in Peru” Liam’s height wouldn’t matter that much because men are much shorter there. Having no immediate plans to move to South America, however, we opted to live in the world of Big Pharma instead.

 

We’ve entered the world of Big Pharma.  At the beginning of this past summer, Liam announced that he was ready for “those shots that make you grow” –and in a sign of how long it takes to get approved for this medicine, we only started the shots last week.

First step? A lovely four-hour blood test, administered while Liam sat in a hospital room, starving hungry because he couldn’t eat until the test was over. That was in June and he’s still angry about it.

Second step? Forms, forms, forms.  Our endocrinologist says that insurance companies make the application process for this drug ridiculously complicated—and in fact there is someone from Pfizer (which makes Genotropin) who comes into endocrinologist’s office once a week “just to help” with the Human Growth Hormone application forms. It seems a little incestuous, don’t you think? Having a rep from Big Pharma in the office, making it easier for you to prescribe HGH to your patients?

Although, of course, as beneficiaries of the nice lady in the doctor’s office, we went through all the various hoops pretty easily. We talked to people at Pfizer, where there is an entire department devoted to Genotropin, including doctors, nurse liaisons, patient care consultants…I talked to about five different departments–probably I could’ve found someone to consult on a new color scheme for the kitchen if I’d asked around.

We talked to the pharmacy reps who order the drug and to the reps who talk to the insurance company–but we couldn’t talk to the insurance company. Liam’s entire case has been handled, more or less, by people sitting in cubicles in anonymous office buildings somewhere in New Jersey–and none of them have ever laid eyes on Liam. After the blood test last summer and a few phone conversations in August, we never heard from our actual endocrinologist.  She’s regularly on those “best doctors in New York” lists—but trying to get her to return a phone call? You’d have better luck mapping a genome with your iPhone GPS (hmm… new app?)

All these nice people sent us literature and videos and dvds about the drug; and “fun” calendars; and even stickers for the “Leap Frog Club:” with every refill of the drug, you get a sticker, and after six stickers, you get a prize. Woo woo. I guess that’s supposed to be consolation for getting stuck with a needle six days a week?

And we got a huge and scary red “Sharps Disposal” container; needles and swabs and a “pen” to inject this wonder drug…And we got the drug itself: a cartridge that we insert into the pen, the way you do an ink cartridge into a fountain pen.  One cartridge is about eight doses of the medicine. Would you like to know how much a cartridge costs, approximately?

700 bucks.

Right. 700 smackeroos. Multiply that by…well, the endocrinologist says that the medicine is supposed to be administered through puberty.  Let’s see. That’s six shots a week times 52 weeks times 5 years.

Comes to about $182,000.  Give or take ten grand. Explains why insurance companies would rather Liam just rolled up his shirt cuffs and got his pants hemmed instead of taking these shots.

Do you suppose if you work for Pfizer and your kid needs HGH you get a discount? Five cartridges for the price of four, something like that?

It feels a little strange, I have to say, to be willingly participating in a system that is so broken (of course, I voted, too, so I guess I’m a sucker for broken systems).

But I’m not going to quibble about the price because Liam needs this stuff:  he’s tiny and not growing very much and he’s filled with angst about his size.  I just got him a new pair of corduroys–size 7 slim–and had to cuff them twice, plus cinch them in at the waist. Probably I could’ve gotten him a size 6, but that’s the size I get for Caleb, and I couldn’t bring myself to buy my 10 year old and my 6 year old the same size pants.

I can still afford to buy my kids pants, though, even after we’ve started this medicine, because we’re among the lucky ones: we have “good insurance,” so the cost to us is minimal. God forbid what would happen if we didn’t have insurance and decided that Liam needed this medicine.

I was thinking the other day about how expensive Liam is. I mean, all kids are black suck-holes of financial need, but Liam?

He’s like our own little Mastercard ad:
Two months in the NICU? Umpteen thousand dollars
Three years (3 months to 3 years) PT and OT through Early Intervention? Umpteen thousand dollars
Five years of HGH? Umpteen gazillion dollars
Liam himself? Priceless

Continue Reading · on August 22, 2013 in Children, growing up, HGH, Kids, Parenting, preemies

Slow growing

“Growth disorder.” It was one item on a checklist of ailments that I was filling out at the dermatologist’s office, where I’d taken Liam so the doctor could inspect a mole on Liam’s back.

“Growth disorder,” on a list with asthma, leukemia, shingles, bleeding tendency (what on earth is that, I wonder? Don’t we all have a tendency to bleed?)…a list of problems long enough to fill the entire sheet of paper.

It’s the “disorder” that gets me, although I suppose, technically, that’s the correct term for why Liam is so short.  Conventional medical wisdom dictates that preemies “catch up” in growth by their second or third year, but true to form, Liam flew in the face of convention. He stayed small, stayed off the growth chart, that ubiquitous measurement of “normal.”  He stayed small to the tune of being always the smallest kid in his grade, so small that people ask him if he and Caleb (who is almost four years younger) are twins.

We’d debated for almost a year about whether or not to give Liam growth hormone. How do you say to your kid that you love him just the way he is, in all his ferocious tiny glory and then say, “but here’s a shot so that you can get bigger and look different?”  My friend Patsy made the analogy to giving a kid braces: no one is going to die from bad teeth, but why not give your kid the advantage of a nice smile? Our endocrinologist said that Liam’s size wouldn’t be an issue…if we lived in Costa Rica. I wasn’t sure exactly what I was supposed to do with that information—plan to send Liam to college in Costa Rica so he can get a date?

In this country, unless you’re the short Clinton cabinet guy, being a man who barely scrapes five feet can be tough. And Liam has shown no interest in horses (or labor policy) so I’m thinking that jockey is no more an option than being Secretary of Labor. Continue Reading →

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Continue Reading · on May 23, 2011 in Children, growing up, HGH, preemies

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