From December 1, 2018 the Australian government extended PBS (Pharmaceutical Benefits Scheme) subsidized Growth Hormone (GH) to Adults with Growth Hormone deficiency. It had previously only been subsidized in children. Whilst adults do not require GH for further growth, it can have beneficial effects on energy levels and quality of life, muscle to fat ratio, bone strength and exercise capacity in those who are deficient. Growth hormone is given via a small daily injection into the subcutaneous fat of the abdomen usually.

Adults with growth hormone deficiency either have had this since childhood, or have developed, usually deficiency of all their pituitary gland hormones due to pituitary area tumours, previous surgery or radiotherapy. They are often taking other replacement hormones such as thyroid hormones, steroids and sex steroids.

The PBS criteria for access of GH in adults are quite stringent and must be be prescribed through an endocrinologist. Currently these are:

1. Failure to produce sufficient GH during a dynamic test of GH production (Insulin Tolerance Test, Arginine Infusion Test or Glucagon Provocation Test)
2. Low serum insulin like growth factor 1 (IGF-1) baseline test
3. Poor score on a quality of life assessment specific for GH deficiency

Most endocrinologists in Western Australia are using Glucagon Provocation Test through one of the tertiary hospitals. These criteria are likely to change during the year as feedback on requirements is received. Contact your endocrinologist if you have growth hormone deficiency and would like to pursue GH replacement.