Cost-Effectiveness Analysis of Reference Recombinant Human Follicle-Stimulating Hormone ALFA (R-HFSH-ALFA) and Urinary Highly Purified Menopausal Gonadotropin (HMG-HP) Based on DATA from a Large German Registry
Author(s)
Bühler K1, Roeder C2, Schwarze JE3, Lispi M4, Allignol A4, D'Hooghe T4, Falla E5, Lukyanov V6, Fischer R7
1Scientific-Clinical Centre for Endometriosis of the University Hospitals of Saarland, Saarbrücken, Germany, 2Pharma Value Consulting, Oberwil, Switzerland, 3the healthcare business of Merck KGaA, Darmstadt, HE, Germany, 4the healthcare business of Merck KGaA, Darmstadt, Germany, 5IQVIA Ltd., Real World Solutions, London, LON, UK, 6IQVIA Solutions B.V., Amsterdam, Netherlands, 7Fertility Centre Hamburg, Hamburg, Germany
Presentation Documents
OBJECTIVES To evaluate the real-world cumulative cost per live birth and cost-effectiveness (incremental cost-effectiveness ratio [ICER]) of reference recombinant human follicle-stimulating hormone-alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG-HP), for up to three cumulative assisted reproductive technologies (ART) cycles (maximum three stimulations and corresponding frozen-embryo transfers). METHODS A decision-tree model was developed from RecDate, using pregnancy and live birth rates for up to three ART cycles using the same gonadotropin as clinical inputs. Clinical inputs for ART cycles were obtained from a German fertility registry (RecDate), including 71 German in-vitro fertilization centres (January 2007–December 2010) (see Bühler et al., Reprod Biol2021;19:90). Costs for ART treatment and drugs were obtained from public sources. Total costs were generated using the proportion of patients at the end of each treatment pathway multiplied by the cost and resource use and total sum of all pathways. Outputs included live-birth rates, costs per live birth, and ICER (difference in costs/difference in cumulative live-birth rates between both treatments). Robustness of the inputs was assessed via sensitivity analyses. RESULTS Treatment with reference r-hFSH-alfa resulted in higher adjusted cumulative live-birth rates versus hMG-HP: 25.3% versus 22.3% after one, 30.9% versus 27.5% after two and 31.9% versus 28.6% after three ART cycles. Total costs per live birth were lower with reference r-hFSH-alfa than hMG-HP: €17,938 versus €20,054 after one, €18,251 versus €20,437 after two and €18,473 versus €20,680 after three ART cycles. The ICER demonstrated that reference r-hFSH-alfa is cost-effective following the first two ART cycles (€2,430 and €836, respectively) and becomes dominant after the third ART cycle. Robustness of the inputs to parameter input variation was confirmed. CONCLUSIONS Based on a large German registry, reference r-hFSH-alfa was cost-effective, with lower costs per live birth compared with hMG-HP.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSC109
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Reproductive and Sexual Health