<br>在 GnRH 拮抗剂方案中受控卵巢过度刺激期间重组 LH 与 hMG 补充 FSH 的直接医疗成本分析,Archives of Gynecology and Obstetrics

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在 GnRH 拮抗剂方案中受控卵巢过度刺激期间重组 LH 与 hMG 补充 FSH 的直接医疗成本分析
Archives of Gynecology and Obstetrics ( IF 2.1 ) Pub Date : 2023-12-15 , DOI: 10.1007/s00404-023-07309-w
Jui-Chun Chang, Yu-Chiao Yi, Ya-Fang Chen, Hwa-Fen Guu, Hsiao-Fan Kung, Li-Yu Chen, Shih-Ting Chuan, Yu-Mei Chang, Ming-Jer Chen

目的

我们之前发表了一项回顾性匹配病例对照研究，比较了重组 LH (r-hLH) 与高纯度人绝经期促性腺激素 (hMG) 补充剂在受控卵巢过度刺激 (COH) 期间对卵泡刺激素 (FSH) 的影响。 GnRH 拮抗剂方案。该研究的结果表明，r-hLH 组的累积活产率 (CLBR) 显着较高（53% vs. 64%， p = 0.02）。在本研究中，我们的目标是根据我们之前的研究对这两组之间进行成本分析。

方法

在我们之前的研究中，分析包括 425 个 IVF 和 ICSI 周期。 r-hFSH + hMG 组有 259 个周期，r-hFSH + r-hLH 组有 166 个周期。记录与每位患者的治疗相关的总费用。进行并创建了概率敏感性分析（PSA）和成本效益可接受性曲线（CEAC）。

结果

r-hFSH + r-hLH 组每名患者的总治疗费用显着高于 r-hFSH + hMG 组（4550 ± 798.86 美元 vs. 4290 ± 734.6 美元， p = 0.003）。然而，r-hFSH + hMG 组每次活产的平均成本较高，为 8052 美元，而 r-hFSH + r-hLH 组为 7059 美元。 CEAC 表明，hFSH + r-hLH 治疗比 r-hFSH + hMG 治疗更具成本效益。当考虑 18,513 美元的假设门槛时，支付意愿很明显，r-hFSH + r-hLH 组有 99% 的可能性被认为具有成本效益。

结论

成本分析表明，在 GnRH 拮抗剂方案中，在 COH 期间重组 LH 比在 r-hFSH 上补充 hMG 更具成本效益。

"点击查看英文标题和摘要"

A direct healthcare cost analysis of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol

Purpose

We have previously published a retrospective matched-case control study comparing the effect of recombinant LH (r-hLH) versus highly purified human menopausal gonadotropin (hMG) supplementation on the follicle-stimulating hormone (FSH) during controlled ovarian hyperstimulation (COH) in the GnRH-antagonist protocol. The result from that study showed that the cumulative live birth rate (CLBR) was significantly higher in the r-hLH group (53% vs. 64%, p = 0.02). In this study, we aim to do a cost analysis between these two groups based on our previous study.

Methods

The analysis consisted of 425 IVF and ICSI cycles in our previous study. There were 259 cycles in the r-hFSH + hMG group and 166 cycles in the r-hFSH + r-hLH group. The total cost related to the treatment of each patient was recorded. Probabilistic sensitivity analysis (PSA) and a cost-effectiveness acceptability curve (CEAC) were performed and created.

Results

The total treatment cost per patient was significantly higher in the r-hFSH + r-hLH group than in the r-hFSH + hMG group ($4550 ± 798.86 vs. $4290 ± 734.6, p = 0.003). However, the mean cost per live birth in the r-hFSH + hMG group was higher at $8052, vs. $7059 in the r-hFSH + r-hLH group. The CEAC showed that treatment with hFSH + r-hLH proved to be more cost-effective than treatment with r-hFSH + hMG. Willingness-to-pay was evident when considering a hypothetical threshold of $18,513, with the r-hFSH + r-hLH group exhibiting a 99% probability of being considered cost-effective.