Highly Purified Human Menopausal Gonadotropin (HP-hMG) Versus Recombinant Follicle-Stimulating Hormone (rFSH) for Controlled Ovarian Stimulation in US Predicted High-Responder Patients: A Cost-Comparison Analysis

Andrew Khair, Tray Brown, Marie Markert, Carsten Rødseth Barsøe, Gaurang S Daftary, Patrick W Heiser, Andrew Khair, Tray Brown, Marie Markert, Carsten Rødseth Barsøe, Gaurang S Daftary, Patrick W Heiser

Abstract

Objectives: Infertility imposes considerable clinical and economic burden, and the high costs of fertility care are a major barrier to payers. This study assessed the cost differences of highly purified human menopausal gonadotropin (HP-hMG) versus recombinant follicle stimulating hormone (rFSH) for controlled ovarian stimulation (COS) protocols in predicted high-responders from the US payer perspective.

Methods: A discrete event simulation model was built to perform a cost-comparison analysis of HP-hMG versus rFSH in a cohort of predicted high-responders undergoing up to three embryo transfer cycles, informed by efficacy data from the MEGASET-HR trial. The model considered an event-based treatment pathway and transition probabilities were derived from MEGASET-HR. A variable time horizon was employed, and deterministic and probabilistic sensitivity analyses conducted.

Results: Subjects undergoing COS with HP-hMG and rFSH demonstrated comparable live birth rates following three in vitro fertilization (IVF) cycles, with 161 live births with HP-hMG and 152 live births with rFSH, per 310 high-responders. The total cost saving per live birth in subjects receiving HP-hMG versus rFSH was US$3024. These cost savings were largely driven by the need for fewer embryo transfers to achieve similar efficacy outcomes and a reduced rate of ovarian hyperstimulation syndrome. Following deterministic sensitivity analysis, HP-hMG remained cost saving in all baseline parameter variations. No parameters led to rFSH providing cost savings when compared with HP-hMG.

Conclusion: Comparable clinical outcomes can be achieved at a lower cost when using HP-hMG versus rFSH based COS protocols in a cohort of predicted high-responders. Such cost savings may reduce the economic burden infertility currently presents to US healthcare providers and those seeking fertility care.

Conflict of interest statement

AK, MM, CB, GD, and PH are employees of Ferring Pharmaceuticals. TB is an employee of Health Economics and Outcomes Research Ltd. who received fees from Ferring Pharmaceuticals in relation to this study.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
Discrete event simulation model schematic. hCG: human chorionic gonadotropin
Fig. 2
Fig. 2
Deterministic sensitivity analysis (excluding cost of delivery). GP: general practice, HP-hMG: highly purified human menopausal gonadotropin, OHSS: ovarian hyperstimulation syndrome, rFSH: recombinant follicle-stimulating hormone
Fig. 3
Fig. 3
Cost-comparison plane (excluding cost of delivery)
Fig. 4
Fig. 4
Probability of HP-hMG providing cost savings versus total cost per live birth for rFSH (excluding cost of delivery). rFSH: recombinant follicle-stimulating hormone

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Source: PubMed

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