In its Final Appraisal Report, the All Wales Medicines Strategy Group (AWMSG) has supported the use of mecasermin (Increlex®) within NHS Wales for the long-term treatment of growth failure in children and adolescents with severe primary insulin-like growth factor-I deficiency. The treatment, which should be initiated and monitored by physicians who are experienced in the diagnosis and management of patients with growth disorders, is not suitable for shared care within NHS Wales.