Cost-effectiveness of preimplantation genetic testing for aneuploidy for fresh donor oocyte cycles
Maria Facadio Antero, M.D.,
Bhuchitra Singh, M.D., M.P.H, M.S.,
Apoorva Pradhan, B.A.M.S., M.P.H.,
Megan Gornet, M.D.,
William G. Kearns, Ph.D.,
Valerie Baker, M.D., M.P.P.,
Mindy S. Christianson, M.D.
Affiliations
Maria Facadio Antero, M.D.
Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; Reprint requests: Maria Facadio Antero, M.D., Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, Maryland 21287.
Bhuchitra Singh, M.D., M.P.H, M.S.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Apoorva Pradhan, B.A.M.S., M.P.H.
Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
Megan Gornet, M.D.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
William G. Kearns, Ph.D.
AdvaGenix, Rockville, Maryland
Valerie Baker, M.D., M.P.P.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Mindy S. Christianson, M.D.
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Objective: To determine whether in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) is cost effective to achieve a live birth compared with IVF alone in fresh donor oocyte cycles. Design: Theoretical cost-effectiveness study. Setting: Not applicable. Patient(s): None. Intervention(s): Comparison between the cost of IVF with PGT-A vs. IVF alone to achieve a live birth. The model analyzed a hypothetical single fresh oocyte donor IVF cycle with PGT-A vs. IVF alone and followed the progression of a single embryo through the different decision nodes. Cost estimates assigned to each clinical event were based on data obtained from the literature and institutional costs. Main Outcome Measure(s): Cost per live birth. Result(s): In the base-case analysis, IVF with PGT-A was not cost effective in fresh donor oocyte cycles when compared with IVF alone to achieve a live birth. The cycles using PGT-A cost an additional $6,018.66. The incremental cost-effectiveness ratio was found to be $119,606.59 per additional live birth achieved with IVF with PGT-A. Monte Carlo simulations demonstrated that IVF with PGT-A was not cost effective in nearly all iterations. Conclusion(s): PGT-A in fresh donor oocyte IVF cycles is not cost effective compared with IVF alone over a wide range of probabilities and costs.
