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/intracy...

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Bibliographic Details
Published in:Reproductive biomedicine online 2006-02, Vol.12 (2), p.163-169
Main Authors: Al-Inany, Hesham G, Abou-Setta, Ahmed M, Aboulghar, Mohamed A, Mansour, Ragaa T, Serour, Gamal I
Format: Article
Language:English
Subjects:
Cost-Benefit Analysis
cost–effectiveness
Developing Countries
Female
Follicle Stimulating Hormone - administration & dosage
HMG
Humans
infertility
Markov Chains
Markov model
Menotropins - administration & dosage
meta-analysis
Ovulation Induction
Pregnancy
recombinant FSH
Recombinant Proteins - administration & dosage
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Summary: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.
ISSN:1472-6483
1472-6491
DOI:10.1016/S1472-6483(10)60856-5