Comparative pharmacoeconomic analysis of using different follicle-stimulating hormone preparations for ovalution stimulation in in vitro fertilization protocols using gonadotropin-releasing hormone antagonists
Objective. To evaluate the pharmacoeconomic feasibility and validity of using a long-acting recombinant follicle-stimulating hormone (rFSH) for the stimulation of ovulation in IVF protocols using gonadotropin-releasing hormone antagonists versus the daily administration of rFSH.Boyarsky K.Yu.
Material and methods. The analysis included data on 613 patients who had undergone ovulation stimulation with different FSH preparations in the IVF protocols using gonadotropin-releasing hormone antagonists in 15 regional assisted reproductive technology (ART) centers of Russia (613 IVF cycles), by applying quality of life questionnaires (EQ-5D-3L and visual analog scale (VAS)). According to the used rFSH preparation to stimulate ovulation, the patients were divided into 4 groups. Mathematical modeling for cost analysis, cost-effectiveness analysis, budget impact analysis, and cost-utility analysis was carried out using data on the regional tariff agreements of the Compulsory Health Insurance Fund (CHIF) and the Federal State Statistics Service; clinical guidelines and published clinical trial results, as well as the regulatory acts of the Ministry of Health of Russia were analyzed.
Results. Analysis of the comparative clinical efficacy of a long-acting recombinant follicle-stimulating hormone (rFSH) revealed no substantial differences in the main clinical performance indicators, such as the number of obtained MII oocytes. In the long-acting recombinant follicle-stimulating hormone (rFSH) group, there was the highest proportion (75%) of the patients who had undergone embryo/blastocyst transfer, while in the the daily administration of rFSH.groups, the transfer was carried out in 67 and 70% of cases, respectively. The cost-effectiveness in the cost of a cycle with a long-acting recombinant follicle-stimulating hormone (rFSH) was 29 and 12% lower than that with the daily administration of rFSH respectively.
Conclusion. The prescription of a long-acting recombinant follicle-stimulating hormone (rFSH) provides the most effective use of the CHIF tariff for IVF and has the lowest share in the cost of this tariff.
Keywords
in vitro fertilization (IVF)
fertilization
oocyte
embryo
blastocyst
recombinant follicle-stimulating hormone (rFSH)
a long-acting recombinant follicle-stimulating hormone (rFSH)
the daily administration of rFSH
clinical efficacy
pharmacoeconomics
cost analysis
cost-effectiveness analysis
budget impact analysis
quality-adjusted life year (QALY)
cost-utility analysis
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Received 07.09.2018
Accepted 21.09.2018
About the Authors
Boyarsky, Konstantin Yu., the associate professor of the Department of Obstetrics and Gynecology named Davydov, Mechnikov, North–West State Medical University. Head of department of reproduction and ART. Reproductive clinic Genesis, Saint Petersburg.Address: 191015, 64 Kirochnaya street, Saint Petersburg, Russia. Tel: +79117220381. E–mail: konstantinboyarsky@icloud.com
For citation: Boyarsky K.Yu. Comparative pharmacoeconomic analysis of using different follicle-stimulating hormone preparations for ovalution stimulation in in vitro fertilization protocols using gonadotropin-releasing hormone antagonists.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 128-36. (in Russian):
https://dx.doi.org/10.18565/aig.2018.11.128-136
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