Фармакоэкономика (Jul 2023)
Comparative pharmacoeconomic analysis of follitropin delta application for superovulation induction during artificial insemination
Abstract
Objective: to conduct a comparative pharmacoeconomic analysis of using follitropin delta for controlled ovarian stimulation in adult women to induce the growth of multiple follicles during cycles of assisted reproductive technology (ART) programs – in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).Material and methods. The available literature was searched for data on clinical effectiveness and safety of follitropin delta and follitropin alfa. Two large studies were found – ESTHER-1 and ESTHER-2 as well as their combined analysis, based on which a decision tree model was built. Considering the presence of a significant difference between safety profile of analyzed follitropins (the frequency of preventive medical interventions in relation to the development of ovarian hyperstimulation syndrome (OHSS)), the cost-effectiveness analysis was used. The cost analysis included only direct medical costs: drugs (treated separately), ART program cycle, relief of complications. As part of the budget impact analysis (BIA), several options for managing patients with infertility were considered: current practice (in 100% of cases, the use of follitropin alfa), simulated practice (transfer of 50% of patients to follitropin delta). Time horizon was IVF/ICSI cycle 1 within ART program for cost-effectiveness analysis, and 1 year for BIA. Results. Despite the fact that the use of follitropin delta is associated with a higher level of drug costs compared to follitropin alfa, the costs of IVF/ICSI cycles within ART programs and the relief of complications are lower with the use of follitropin delta. The total costs for the Cycle 1 amounted to 132,123.99 rubles with the use of follitropin delta, and 133,392.19 rubles with the use of follitropin alfa. The total costs for three cycles were 200,952.17 rubles with the use of follitropin delta, and 204,296.62 rubles with the use of follitropin alfa (2% difference). The costs per 1 case of no medical interventions due to OHSS for follitropin delta amounted to 135,234.38 rubles, which is 3.2% less compared to the same indicator for follitropin alfa (139,677.69 rubles). BIA demonstrated that the use of follitropin delta will reduce the economic burden on the healthcare system by 49.5 million rubles within 1 year.Conclusion. According to the results of the study, the use of follitropin delta individual dosing regimen for controlled ovarian stimulation in adult patients as part of IVF/ICSI cycles within ART programs is effective and economically justified approach to organizing medical care for adult patients with infertility in Russia.
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