Recombinant or urinary follicle-stimulating hormone? A cost-effectiveness analysis derived by particularizing the number needed to treat from a published meta-analysis.
OBJECTIVE
To demonstrate that particularizing pooled results of a meta-analysis can derive incremental cost effectiveness of superovulation with recombinant follicle-stimulating hormones (rFSH) vs. the highly purified urinary form (uFSH) for assisted conception.


METHODS
A retrospective study.


METHODS
An assisted conception unit in the United Kingdom.


METHODS
One hundred forty-five fresh in vitro fertilization (IVF) and 58 fresh intracytoplasmic sperm injection (ICSI) cycles.


METHODS
rFSH vs. uFSH.


METHODS
Incremental cost-effectiveness (i.e., cost needed to treat, or CNT) and budget-impact analyses of rFSH vs. uFSH.


RESULTS
In women less than 30 years old, the clinical pregnancy rate was 37.7% (95% CI 24.8%-52.1%), the particularized number needed to treat (pNNT) was -19, and the cost needed to treat was 5070.51 pounds sterling (3660.53 pounds sterling to 7619.32 pounds sterling). For the 30- to 35-year-old age group, the clinical pregnancy rate was 29.9% (95% CI 20.0%--41.4%), the particularized number needed to treat was -24, and CNT was 7335.59 pounds stering (5284.11 pounds sterling to 10,941.22 pounds sterling). For the 36- to 40-year-old age group, the clinical pregnancy rate was 30.6.0% (95% CI 19.6%--43.7%), the particularized number needed to treat was -23.0, and the CNT was 8569.67 pounds sterling (5998.70 pounds sterling to 13,413.24 pounds sterling).


CONCLUSIONS
The CNT and thus the budget impact analyses (the extra number of cycles that can be funded by the CNT) both increase directly with age of the patient, and inversely with the clinical pregnancy rate.
Ola
B
B
Assisted Conception Unit, Birmingham Women's Hospital, Edgbaston, United Kingdom. bolarinde.ola@bham-women.thenhs.com
Papaioannou
S
S
Afnan
M A
MA
Hammadieh
N
N
Gimba
S
S
D000328:Adult; D000375:Aging / Q000502:physiology; D002017:Budgets; D003362:Cost-Benefit Analysis; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use* / Q000652:urine*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000191:economics*
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone