title: Cost-effectiveness of recombinant versus urinary follicle-stimulating hormone in assisted reproduction techniques in the Spanish public health care system.
abstract: OBJECTIVE
  To evaluate the relative cost-effectiveness of recombinant and urinary follicle-stimulating hormone (FSH) in assisted reproduction techniques in the Spanish National Health Service.
  
  
  METHODS
  Markov modelling was used to compare costs and outcomes of three complete treatment cycles using recombinant or urinary FSH for controlled ovarian stimulation. Cost and effectiveness estimates were obtained from the literature and from Spanish clinicians. A Monte Carlo technique was used to randomise the distribution of outcomes at each stage. The analysis was performed by passing a virtual population of 100,000 patients through the computer simulation in each of 5000 Monte Carlo simulations.
  
  
  RESULTS
  The cost per pregnancy was Euro12,791+/-1202 ($11,346+/-1066) with recombinant and Euro13,007+/-1319 ($11,537+/-1170) with urinary FSH (p < 0.0001). The mean number of cycles per pregnancy was 4.69 and 5.21, respectively.
  
  
  CONCLUSIONS
  Recombinant FSH is more cost-effective than urinary FSH in the Spanish public health care system.
authors.affiliation: Department of Gynecology (Human Reproduction), Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Romeu
authors.forename: Juan
authors.initials: J
authors.lastname: Balasch
authors.forename: José A
authors.initials: JA
authors.lastname: Ruiz Balda
authors.forename: Pedro N
authors.initials: PN
authors.lastname: Barri
authors.forename: Salim
authors.initials: S
authors.lastname: Daya
authors.forename: Jean P
authors.initials: JP
authors.lastname: Auray
authors.forename: Gerald
authors.initials: G
authors.lastname: Duru
authors.forename: Ariel
authors.initials: A
authors.lastname: Beresniak
authors.forename: José A
authors.initials: JA
authors.lastname: Peinado
mesh_terms: D005260:Female; D005640:Follicle Stimulating Hormone / Q000191:economics* / Q000652:urine; D006801:Humans; D008390:Markov Chains; D011247:Pregnancy; D011994:Recombinant Proteins / Q000191:economics*; D027724:Reproductive Techniques, Assisted / Q000191:economics*; D013030:Spain
chemical_list: D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone