In the absence of a submission from the holder of the marketing authorisation, somatropin (Somatropin Biopartners®) cannot be endorsed for use within NHS Wales for the replacement therapy of endogenous growth hormone in adults with childhood- or adult-onset growth hormone deficiency (GHD). • Adult-onset: Patients with GHD in adulthood are defined as patients with known hypothalamic-pituitary pathology and at least one additional known deficiency of a pituitary hormone not being prolactin. These patients should undergo a single dynamic test in order to diagnose or exclude a GHD. • Childhood-onset: In patients with childhood-onset isolated GHD (no evidence of hypothalamic-pituitary disease or cranial irradiation), two dynamic tests should be performed after completion of growth, except for those having low insulin-like-growth-factor-1 (IGF-1) concentrations (< -2 standard deviation score [SDS]), who may be considered for one test. The cut-off point of the dynamic test should be strict.