METHODOLOGY USING PHARMACY AND MEDICAL CLAIMS DATA TO EVALUATE REAL-WORLD OUTCOMES AND COSTS OF IVF TREATMENT IN THE US
Author(s)
Corvino FA1, Surinach A1, Locklear JC2, Howe AM2, Hayward B2, Mahony MC2
1Genesis Research, LLC, Hoboken, NJ, USA, 2EMD Serono, Inc., Rockland, MA, USA
OBJECTIVES: To describe the methodology used to identify treatment cycles and determine real-world outcomes associated with the in vitro fertilization (IVF) treatments, follicle-stimulating hormone (FSH) versus FSH+human menopausal gonadotropin (hMG), using administrative claims data. METHODS: This retrospective study used the Truven Healthcare MarketScan® Claims Database to identify and compare IVF treatment protocols, pregnancy and birth outcomes among women aged 18–<35 undergoing IVF between January 2009 and December 2012. Patients with ≥1 claim for a gonadotropin-releasing hormone agonist (GnRHAg) or antagonist (GnRHAnt) (first claim being the index date), ≥1 claim for FSH and ≥1 claim for human chorionic gonadotropin (hCG), using National Drug Codes, were selected. Patients were included on identification of a prescription for FSH in the 7 days pre-index through 60 days post-index, hCG in the 60 days post-index and ≥1 embryo transfer (ET) code (using current procedural terminology) ≤60 days post-index. The FSH+hMG cohort also required identification of ≥1 claim for hMG ≤60 days post-index. Patient eligibility was defined as continuous enrollment for 12 months prior and 18 months post-index. ICD-9-CM codes were used to identify live birth outcomes within 42 weeks of ET. RESULTS: Inclusion/exclusion criteria identified 627 and 852 patients in the FSH and FSH+hMG cohorts, respectively. The 18-month post-index eligibility criteria accounted for a large number of patients removed (n=7366). No differences in first-cycle outcomes were seen between FSH and FSH+hMG for: live birth per ET (38.1% vs 38.5%; OR 1.02 [95%CI: 0.82–1.26], p=0.871) and live birth per pregnancy (54.44% vs 54.37%; OR 1.00 [95%CI: 0.78–1.28], p=0.98), respectively. CONCLUSIONS: Most published analyses of fertility treatment outcomes are derived from single fertility center datasets. This methodology successfully identified two distinct IVF treatment protocols and allowed comparison of outcomes using real-world healthcare claims data sourced from a variety of fertility centers.
Conference/Value in Health Info
2015-05, ISPOR 2015, Philadelphia, PA, USA
Value in Health, Vol. 18, No. 3 (May 2015)
Code
PRM33
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Reproductive and Sexual Health