HMG versus rFSH for ovulation induction in developing countries: a cost-effectiveness analysis based on the results of a recent meta-analysis.
Both cost and effectiveness should be considered conjointly to aid judgments about drug choice. Therefore, based on the results of a recent published meta-analysis, a Markov model was developed to conduct a cost-effectiveness analysis for estimation of the cost of an ongoing pregnancy in IVF/intracytoplasmic sperm injection (ICSI) cycles. In addition, Monte Carlo micro-simulation was used to examine the potential impact of assumptions and other uncertainties represented in the model. The results of the study reveal that the estimated average cost of an ongoing pregnancy is 13,946 Egyptian pounds (EGP), and 18,721 EGP for a human menopausal gonadotrophin (HMG) and rFSH cycle respectively. On performing a sensitivity analysis on cycle costs, it was demonstrated that the rFSH price should be 0.61 EGP/IU to be as cost-effective as HMG at the price of 0.64 EGP/IU (i.e. around 60% reduction in its current price). The difference in cost between HMG and rFSH in over 100,000 cycles would result in an additional 4565 ongoing pregnancies if HMG was used. Therefore, HMG was clearly more cost-effective than rFSH. The decision to adopt a more expensive, cost-ineffective treatment could result in a lower number of cycles of IVF/ICSI treatment undertaken, especially in the case of most developing countries.
The Egyptian IVF-ET Centre, Maadi, and Cairo University, Department of Obstetrics and Gynecology, Cairo, Egypt. kaainih@link.net
Hesham G
HG
Al-Inany
Ahmed M
AM
Abou-Setta
Mohamed A
MA
Aboulghar
Ragaa T
RT
Mansour
Gamal I
GI
Serour
D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D008390:Markov Chains; D008596:Menotropins / Q000008:administration & dosage*; D010062:Ovulation Induction; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage
D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone