title: A cost per live birth comparison of HMG and rFSH randomized trials.
abstract: To help inform healthcare treatment practices and funding decisions, an economic evaluation was conducted to compare the two leading gonadotrophins used for IVF in Belgium. Based on the results of a recently published meta-analysis, a simulated decision tree model was constructed with four states: (i) fresh cycle, (ii) cryopreserved cycle, (iii) live birth and (iv) treatment withdrawal. Gonadotrophin costs were based on highly purified human menopausal gonadotrophin (HP-HMG; Menopur) and recombinant FSH (rFSH) alpha (Gonal-F). After one fresh and one cryopreserved cycle the average treatment cost with HP-HMG was lower than with rFSH (HP-HMG euro3635; rFSH euro4103). The average cost saving per person started on HP-HMG when compared with rFSH was euro468. Additionally, the average costs per live birth of HP-HMG and rFSH were found to be significantly different: HP-HMG euro9996; rFSH euro13,009 (P < 0.0001). HP-HMG remained cost-saving even after key parameters in the model were varied in the probabilistic sensitivity analysis. Treatment with HP-HMG was found to be the dominant treatment strategy in IVF because of improved live birth rates and lower costs. Within a fixed healthcare budget, the cost-savings achieved using HP-HMG would allow for the delivery of additional IVF cycles.
authors.affiliation: Market Access, Ferring International Centre, St. Prex, Switzerland. mark@gmasoln.com
authors.forename: Mark
authors.initials: M
authors.lastname: Connolly
authors.forename: Kathleen
authors.initials: K
authors.lastname: De Vrieze
authors.forename: Willem
authors.initials: W
authors.lastname: Ombelet
authors.forename: Dirk
authors.initials: D
authors.lastname: Schneider
authors.forename: Craig
authors.initials: C
authors.lastname: Currie
mesh_terms: D003362:Cost-Benefit Analysis; D015925:Cryopreservation; D004470:Economics, Medical; D005260:Female; D005640:Follicle Stimulating Hormone / Q000191:economics*; D006801:Humans; D050498:Live Birth / Q000191:economics; D008596:Menotropins / Q000191:economics*; D016471:Ovarian Hyperstimulation Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D011336:Probability; D011994:Recombinant Proteins / Q000191:economics; D027724:Reproductive Techniques, Assisted / Q000191:economics; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D008596:Menotropins; D005640:Follicle Stimulating Hormone