Cost-effectiveness of recombinant versus urinary follicle-stimulating hormone in assisted reproduction techniques in the Spanish Public Health Care System

• Published in: Journal of assisted reproduction and genetics Vol. 20; no. 8; pp. 294 - 300
• Main Authors: ROMEU, Alberto, BALASCH, Juan, RUIZ BALDA, José A, BARRI, Pedro N, DAYA, Salim, AURAY, Jean P, DURU, Gerald, BERESNIAK, Ariel, PEINADO, José A
• Format: Journal Article
• Language: English
• Published: New York, NY Kluwer/Plenum 01-08-2003; Springer Nature B.V; Kluwer Academic Publishers-Plenum Publishers
• Subjects: Biological and medical sciences; Female; Follicle Stimulating Hormone - economics; Follicle Stimulating Hormone - urine; Genital system. Reproduction; Humans; Markov Chains; Medical sciences; Pharmacology. Drug treatments; Pregnancy; Recombinant Proteins - economics; Reproductive Techniques, Assisted - economics; Spain; Europe; Spain; Urofollitropin; Ovulation inducer; Assisted procreation; recombinant human FSH; Gonadotropin; Markov model; urinary FSH; Care; Markov modelling; Spain; Adenohypophyseal hormone; Recombinant protein; Technique; Cost-effectiveness; Public health; Cost efficiency analysis; Follicle stimulating hormone
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1023/A:1024899806149

To evaluate the relative cost-effectiveness of recombinant and urinary follicle-stimulating hormone (FSH) in assisted reproduction techniques in the Spanish National Health Service.
Markov modelling was used to compare costs and outcomes of three complete treatment cycles using recombinant or urinary FSH for controlled ovarian stimulation. Cost and effectiveness estimates were obtained from the literature and from Spanish clinicians. A Monte Carlo technique was used to randomise the distribution of outcomes at each stage. The analysis was performed by passing a virtual population of 100,000 patients through the computer simulation in each of 5000 Monte Carlo simulations.
The cost per pregnancy was Euro12,791+/-1202 ($11,346+/-1066) with recombinant and Euro13,007+/-1319 ($11,537+/-1170) with urinary FSH (p < 0.0001). The mean number of cycles per pregnancy was 4.69 and 5.21, respectively.
Recombinant FSH is more cost-effective than urinary FSH in the Spanish public health care system.