Article ID Journal Published Year Pages File Type
3971747 Reproductive BioMedicine Online 2010 13 Pages PDF
Abstract

The economic implications of the choice of gonadotrophin influence decision making but their cost-effectiveness in frozen-embryo transfer cycles has not been adequately studied. An economic evaluation was performed comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) using individual patient data (n = 986) from two large randomized controlled trials using a long agonist IVF protocol. The simulation model incorporated live birth data and published UK costs of IVF-related medical resources. After treatment for up-to-three cycles (one fresh and up to two subsequent fresh or frozen cycles conditional on availability of cryopreserved embryos), the cumulative live birth rate was 53.7% (95% CI 49.3–58.1%) for HP-HMG and 44.6% (40.2–49.0%) for rFSH (OR 1.44, 95% CI 1.12–1.85; P < 0.005). The mean costs per IVF treatment for HP-HMG and rFSH were £5393 (£5341–5449) and £6269 (£6210–6324), respectively (number needed to treat to fund one additional treatment was seven; P < 0.001). With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was £11,157 (£11,089–11,129) and £14,227 (£14,183–14,222) with rFSH (P < 0.001). The cost saving using HP-HMG remained after varying model parameters in a probabilistic sensitivity analysis.

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