This guidance updates and replaces NICE technology appraisal 42 (published in May 2002).

A minor correction was made to section 6.1 of the guidance in July 2010. This does not affect the funding direction, which applies from the original date of publication in May 2010.

NICE recommends human growth hormone (somatropin) as a possible treatment for some children with growth failure (see below).

Who can have human growth hormone (somatropin)?

Children should be able to have human growth hormone (somatropin) if they have any of the following:

  • growth hormone deficiency
  • Turner syndrome
  • Prader–Willi syndrome
  • chronic renal insufficiency
  • growth failure at 4 years or older and were born small for gestational age
  • short stature homeobox-containing gene (SHOX) deficiency.

Treatment should continue until the child stops growing unless growth is slow in the first year of treatment or the child doesn’t wish to carry on with the treatment. The specialist should carefully consider weight and height before stopping treatment in children with Prader–Willi syndrome.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE recommended human growth hormone (somatropin) because it increases growth in children with growth failure and works well in relation to its cost.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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