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 and Patrick W. Heiser ()
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Andrew Khair: Ferring Pharmaceuticals, Inc.
Tray Brown: Health Economics and Outcomes Research (HEOR) Ltd.
Marie Markert: Ferring Pharmaceuticals A/S
Carsten Rødseth Barsøe: Ferring Pharmaceuticals A/S
Gaurang S. Daftary: Ferring Pharmaceuticals A/S
Patrick W. Heiser: Ferring Pharmaceuticals, Inc.

PharmacoEconomics - Open, 2023, vol. 7, issue 5, No 12, 860 pages

Abstract: 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.

Date: 2023
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DOI: 10.1007/s41669-023-00429-8

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