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Fertil Steril. 2009 Apr;91(4):1067-76. doi: 10.1016/j.fertnstert.2008.01.034. Epub 2008 Mar 12.

Cost-saving treatment strategies in in vitro fertilization: a combined economic evaluation of two large randomized clinical trials comparing highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone alpha.

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1
Health Economics, Cardiff Research Consortium, Cardiff, United Kingdom.

Abstract

OBJECTIVE:

To assess the cost-effectiveness of two gonadotropin treatments that are available in the United Kingdom in light of limited public funding and the fundamental role of costs in IVF treatment decisions.

DESIGN:

An economic evaluation based on two large randomized clinical trials in IVF patients using a simulation model.

SETTING:

Fifty-three fertility clinics in 13 European countries and Israel.

PATIENT(S):

Women indicated for treatment with IVF (N = 986), aged 18-38, participating in double-blind, randomized controlled trials.

INTERVENTION(S):

Highly purified menotropin (HP-hMG, Menopur) or recombinant follitropin alpha (rFSH, Gonal-F).

MAIN OUTCOME MEASURE(S):

Cost per IVF cycle and cost per live birth for HP-hMG and rFSH alpha.

RESULT(S):

HP-hMG was more effective and less costly versus rFSH for both IVF cost per live birth and for IVF cost per baby (incremental cost-effectiveness ratio was negative). The mean costs per IVF treatment for HP-hMG and rFSH were 2408 pounds (95% confidence interval [CI], 2392 pounds, 2421 pounds) and 2660 pounds (95% CI 2644 pounds, 2678 pounds), respectively. The mean cost saving of 253 pounds per cycle using HP-hMG allows one additional cycle to be delivered for every 9.5 cycles.

CONCLUSION(S):

Treatment with HP-hMG was dominant compared with rFSH in the United Kingdom. Gonadotropin costs should be considered alongside live-birth rates to optimize outcomes using scarce health-care resources.

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