Economic evaluation of GnRH-agonist long protocol and GnRH-antagonist protocol in IVT/ICSI among the Chinese population: using pharmacoeconomic models

作者全名："Si, Yuxin; Chen, Chunlan; Tang, Yalan; Zhang, Min; Tang, Junying; Pu, Kexue"

作者地址："[Si, Yuxin; Chen, Chunlan; Zhang, Min; Pu, Kexue] Chongqing Med Univ, Sch Med Informat, Chongqing, Peoples R China; [Tang, Yalan] Chongqing Med Univ, Sch Pharm, Chongqing, Peoples R China; [Tang, Junying] Chongqing Med Univ, Affiliated Hosp 1, Dept Gynecol & Obstet, Chongqing, Peoples R China"

通信作者："Pu, KX (通讯作者)，Chongqing Med Univ, Sch Med Informat, Chongqing, Peoples R China."

来源：BMJ OPEN

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001311606600001

JCR分区：Q1

影响因子：2.9

年份：2024

卷号：14

期号：8

开始页：　

结束页：　

文献类型：Article

关键词：health economics; reproductive medicine; health policy; subfertility

摘要："Objective This paper uses health economics methods to discuss the cost-effectiveness value of long protocol and antagonist protocol for in vitro fertilisation and embryo transfer (ET) in the Chinese population. Design Health economic evaluation study. Setting The data needed to construct the model for this study were derived from published studies and other secondary sources in China. Participants No patients participated in the study. Measures The main outcomes were live birth rate (LBR) and cost. From the societal perspective, we considered the direct and indirect costs over the course of the treatment cycles. A cost-effectiveness was measured using the incremental cost-effectiveness ratio and the probability that a protocol has higher net monetary benefit. Sensitivity analysis was carried out to verify the reliability of the simulation results. Results For the Chinese population, the long protocol resulted in a higher LBR than the antagonist protocol (29.33% vs 20.39%), but at the same time, it was more expensive ((sic)29 146.26 (US$4333.17) vs.23 343.70 (US$3470.51)), in the case of considering only one fresh ET cycle. It was the same when considering subsequent frozen ET (FET) cycles (51.78% vs 42.81%;.30 703.02 (US$4564.62) vs.24 740.95 (US$3678.24)). The results of most subgroups were consistent with the results of the basic analysis. However, for certain populations, the long protocol was the inferior protocol (less effective and more expensive). Conclusion For the Chinese population, when the monetary value per live birth was greater than.65 420 (US$9726) and.66400 (US$9872), respectively, considering only one fresh cycle and considering subsequent frozen cycles, the long protocol is the preferred protocol. This threshold also varies for women of different ages and ovarian response capacities. For women in POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) group 2, group 3 and group 4, antagonist protocol is recommended as the preferred protocol. The results of this study need to be verified by further large-scale randomised controlled trials."

基金机构：National Social Science Fund [22XGL012]; Future Medical Research Innovation Team Project of Chongqing Medical University [W0081]; Philosophy and Social Sciences Innovation Team Project of Chongqing Medical University [ZX190101]; Special research and development plan of smart medicine for Postgraduates of Chongqing Medical University [YJSZHYX202202]

基金资助正文：This study was supported by grants from (1) National Social Science Fund (22XGL012); (2) Future Medical Research Innovation Team Project of Chongqing Medical University (W0081); (3) Philosophy and Social Sciences Innovation Team Project of Chongqing Medical University (ZX190101) and (4)The Special research and development plan of smart medicine for Postgraduates of Chongqing Medical University (YJSZHYX202202).