Sixty percent of children and adolescents who receive growth hormone injections in Korea do so for “height growth” rather than treatment, and the supply of growth hormone injections was estimated to total 480 billion won ($348 million) in 2023.

On Friday, the National Evidence-based Healthcare Coordinating Agency (NECA) released the results of a study analyzing the use of growth hormone injections. The study is the first to comprehensively examine the use of growth hormone in the non-reimbursed sector.

Growth hormone therapy is widely used as an effective treatment for patients with stunted growth with specific medical indications, including growth hormone deficiency. However, the use of injectable growth hormone for height growth is increasing in Korea, especially among children and adolescents who have not been diagnosed with short stature. As a result, reports of adverse events are increasing every year.

When a team of researchers surveyed 1,000 parents of children who had used growth hormone injections in the past five years, about 60 percent of respondents said that they had used the injections for height growth, even though they had no health problems.

Notably, one in six of these children was taller than the average height for children their age. Less than half (41 percent) of the children were short-statured, which is the criteria for insurance coverage of growth hormone injections, meaning they were shorter than the third shortest out of 100 children their age.

However, after systematically analyzing Korean and international literature, the team found no studies that addressed the safety and efficacy of growth hormone treatment in children with normal height without disease.

The team analyzed the available supply of injectables in Korea and health insurance claims data and found that the use of growth hormone injections in children and adolescents is increasing every year. In 2023, the supply of growth hormone injections was valued at about 480 billion won, more than 2.5 times higher than in 2019. The supply volume has also maintained an average annual increase.

When analyzing the medical department's supply, pediatrics accounted for 54.0 percent of the total in 2023, followed by general medicine with 34.9 percent.

By region, Seoul and Gyeonggi Province accounted for 41.7 percent and 20.0 percent, respectively. In Seoul, Gangnam-gu accounted for 278 of the total number of nursing institutions that received growth hormone injections, 22.5 percent, followed by Seocho-gu with 126 (10.2 percent) and Songpa-gu with 88 (7.1 percent).

In 2023, the number of patients claiming health insurance benefits was 37,017, about seven to eight times higher than 10 years ago. The supply of growth hormone injections and the amount of billing increased in all medical institutions year by year, but by type of medical institution, the proportion of tertiary general hospitals gradually decreased, and the share of clinic-level medical institutions increased.

Over the past 10 years, from 2014 to 2023, 6,309 adverse events related to growth hormone injections were reported to the Korea Institute of Drug Safety and Risk Management.

The most common adverse events were pain at the injection site and pain during injection, which accounted for 24.2 percent, followed by injection site bleeding, bruising, and swelling. Two serious events, death and carcinoma, were also reported but were either not related to growth hormones or could not be evaluated.

“This is the first study to comprehensively analyze the use of growth hormone injections in Korea using the best available data sources,” said Yoon Ji-eun, a research fellow at NECA. “It will serve as a basis for correcting the social perception of growth hormone treatment and creating a safe medical environment based on scientific evidence.”