Patient and Caregiver Preferences for Once-Weekly Injection Devices for the Treatment of Growth Hormone Deficiency

Context: Once-weekly long-acting growth hormone (GH) analogue (LA-GHA) treatments offer an alternative to once-daily GH injections for the treatment of children and adults with GH deficiency (GHD). With these new LA-GHA options, it is important to understand patients' and caregivers' treatment preferences. Objective: This work aimed to understand the injection/device attributes important to patients with GHD and caregivers when choosing LA-GHA treatment options. Methods: In this cross-sectional study, a targeted literature review and qualitative interviews informed the development of an online survey. The survey included a discrete choice experiment, comprising a series of choice tasks. Respondents selected between hypothetical, experimentally designed, once-weekly LA-GHA device features corresponding to currently available devices. Study participants were patients/caregivers in the United States, self-reporting a GHD diagnosis and current short-acting GH injection use: adults (aged ≥18 years), caregivers of children (aged 3-11 years), and dyads of adolescents (aged 12-17 years) and their caregivers. Results: In total, 100 participants completed the survey: 50 adults, 25 caregivers, and 25 adolescent/caregiver dyads. Overall, the most important LA-GHA attributes identified were postinjection pain (27%), the number of injections needed for 1 full dose (23%), and the time needed to prepare the device before each injection (16%). The profile similar to somapacitan-beco had the highest predicted choice probability (82%) compared with the profiles similar to lonapegsomatropin-tcgd (16%) and somatrogon-ghla (2%). Conclusion: Understanding patient and caregiver preferences for LA-GHA devices with less injection pain and greater ease of use highlights the value of shared decision-making, potentially leading to better treatment adherence and subsequent clinical outcomes.