The cost-effectiveness of IVF in the UK: a comparison of three gonadotrophin treatments.
BACKGROUND
The objective of this study was to evaluate the cost-effectiveness of women undergoing IVF treatment with recombinant FSH (rFSH) in comparison with highly purified urinary FSH (uFSH-HP) and human menopausal gonadotrophins (HMG).


METHODS
A decision-analytic model was used to estimate cost-effectiveness ratios for 'the average cost per ongoing pregnancy' and 'incremental cost per additional pregnancy' for women entering into IVF treatment for a maximum of three cycles. The model was constructed based on a previously published large prospective randomized clinical trial comparing rFSH and uFSH-HP. Where necessary, these data were augmented with a combination of expert opinion, evidence from the literature and observational data relating to the management and cost of IVF treatment in the UK. The cost of rFSH, uFSH-HP and HMG were obtained from National Health Service list prices in the UK.


RESULTS
The model predicted a cumulative pregnancy rate after three cycles of 57.1% for rFSH and 44.4% for both uFSH-HP and HMG. The cost of IVF treatment was 5135 pounds sterling for rFSH, 4806 pounds sterling for uFSH-HP and 4202 pounds sterling for HMG. When assessed in association with outcomes, the average cost per ongoing pregnancy was more favourable with rFSH (8992 pounds sterling) than with either uFSH-HP (10 834 pounds sterling) or HMG (9472 pounds sterling). The incremental cost per additional pregnancy was 2583 pounds sterling using rFSH instead of uFSH-HP and 7321 pounds sterling using rFSH instead of HMG. These results were robust to changes in the baseline assumptions of the model.


CONCLUSIONS
rFSH is a cost-effective treatment strategy in ovulation induction prior to IVF.
Sykes
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Organon Laboratories, Cambridge Science Park, Milton Road, Cambridge CB4 0FL, UK .
Out
H J
HJ
Palmer
S J
SJ
van Loon
J
J
D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use* / Q000652:urine; D006801:Humans; D008596:Menotropins / Q000191:economics / Q000627:therapeutic use*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D006113:United Kingdom
D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone