COST-EFFECTIVENESS OF RECOMBINANT HUMAN FOLLICLE-STIMULATING HORMONE COMBINED WITH RECOMBINANT HUMAN LUTEINIZING HORMONE (R-HFSH R-HLH) VERSUS HUMAN MENOPAUSAL GONADOTROPIN (HMG) IN OVARIAN STIMULATION FOR ASSISTED REPRODUCTION IN GERMANY
Author(s)
Robert Fischer, Dr1, Holger Aust, PhD2, Juan Enrique Schwarze, MSc, MD3, Claudia Roeder, PhD3, I-HSUAN WU, PhD3, Adam Christopher Lloyd, MPhil4, David Wastlund, Masters5.
1MVZ Fertility Center Hamburg, Hamburg, Germany, Hamburg, Germany, 2Databraineo, Amsterdam, Netherlands, 3Merck Healthcare KGaA, Darmstadt, Germany, 4Vista Heath Pte Ltd, London, United Kingdom, 5Vista Heath Pte Ltd, Perth, Australia.
1MVZ Fertility Center Hamburg, Hamburg, Germany, Hamburg, Germany, 2Databraineo, Amsterdam, Netherlands, 3Merck Healthcare KGaA, Darmstadt, Germany, 4Vista Heath Pte Ltd, London, United Kingdom, 5Vista Heath Pte Ltd, Perth, Australia.
OBJECTIVES: To assess the cost effectiveness of recombinant human follicle stimulating hormone combined (r-hFSH) with recombinant human luteinizing hormone (r-hLH) versus human menopausal gonadotropin (hMG) as ovarian stimulation regimens for infertility treatment in assisted reproductive technology, from the perspective of the German healthcare system.
METHODS: A decision-tree model was developed using clinical data from a meta-analyses and real-world data from the German IVF registry (Deutsches IVF-Register [D.I.R]). Patients underwent ovarian stimulation in preparation for in vitro fertilization or intracytoplasmic sperm injection. The model compared r-hFSH:r-hLH versus hMG used in one stimulation cycle, including one fresh and up to four frozen embryo transfers. Model inputs included probabilities of clinical pregnancy, oocyte retrieval, embryo transfer, and live birth; counts of oocytes & embryos; costs from per-cycle stimulation through live birth (drug costs, ART procedures, pregnancy, and birth expenses). Costs were estimated from German healthcare perspective and validated with a German clinician. The primary outcome was cost per live birth (cost/LB); secondary outcomes included pregnancy rates, live birth rates (LBR), number of oocytes retrieved and number of fertilized embryos.
RESULTS: The LBR was higher with r-hFSH: r-hLH versus hMG (21.15% vs.18.65%; absolute difference 2.50%). Mean number of oocytes retrieved per stimulation cycle was also higher with r-hFSH:r-hLH versus hMG (7.81 vs 6.38; absolute difference 1.43). Total cycle cost per woman were higher for r-hFSH:r-hLH versus hMG (€6,206 vs €5,870). However, cost/LB was lower with r-hFSH:r-hLH (€29,343 vs €31,470). Cost per oocyte retrieved was also lower with r-hFSH:r-hLH versus hMG (€794.16 vs €919.79). Sensitivity analysis suggested findings were robust to plausible variation in input parameters.
CONCLUSIONS: Compared with hMG, r-hFSH: r-hLH was associated with higher LBR and more oocytes retrieved. The r-hFSH: r-hLH resulted in a lower cost per live birth, suggesting it may be a cost-effective option for ovarian stimulation in ART in Germany.
METHODS: A decision-tree model was developed using clinical data from a meta-analyses and real-world data from the German IVF registry (Deutsches IVF-Register [D.I.R]). Patients underwent ovarian stimulation in preparation for in vitro fertilization or intracytoplasmic sperm injection. The model compared r-hFSH:r-hLH versus hMG used in one stimulation cycle, including one fresh and up to four frozen embryo transfers. Model inputs included probabilities of clinical pregnancy, oocyte retrieval, embryo transfer, and live birth; counts of oocytes & embryos; costs from per-cycle stimulation through live birth (drug costs, ART procedures, pregnancy, and birth expenses). Costs were estimated from German healthcare perspective and validated with a German clinician. The primary outcome was cost per live birth (cost/LB); secondary outcomes included pregnancy rates, live birth rates (LBR), number of oocytes retrieved and number of fertilized embryos.
RESULTS: The LBR was higher with r-hFSH: r-hLH versus hMG (21.15% vs.18.65%; absolute difference 2.50%). Mean number of oocytes retrieved per stimulation cycle was also higher with r-hFSH:r-hLH versus hMG (7.81 vs 6.38; absolute difference 1.43). Total cycle cost per woman were higher for r-hFSH:r-hLH versus hMG (€6,206 vs €5,870). However, cost/LB was lower with r-hFSH:r-hLH (€29,343 vs €31,470). Cost per oocyte retrieved was also lower with r-hFSH:r-hLH versus hMG (€794.16 vs €919.79). Sensitivity analysis suggested findings were robust to plausible variation in input parameters.
CONCLUSIONS: Compared with hMG, r-hFSH: r-hLH was associated with higher LBR and more oocytes retrieved. The r-hFSH: r-hLH resulted in a lower cost per live birth, suggesting it may be a cost-effective option for ovarian stimulation in ART in Germany.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE416
Topic
Clinical Outcomes, Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Reproductive & Sexual Health