Pharmacoeconomic analysis of infertility treatment in women with a suboptimal ovarian response


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To determine a drug that is predominant in terms of pharmacoeconomic analysis for the treatment of infertility in patients with an insufficient ovarian response. Material and methods. An information search for publications on the appropriate topic of this study was conducted in the PubMed, Medlink, and Cochrane Library databases. A total of 134 articles and abstracts were found. Two publications on an open prospective randomized controlled trial by Ferraretti et al. (2004) and an open randomized trial by Carone et al. (2012) were selected for further analysis. These articles are unique in the contents and design of the study. Results. It was established that there was presently a limited number of studies available on the treatment of infertility in women with a suboptimal ovarian response, which had been conducted on a large sample of patients. An economic evaluation of the effectiveness of infertility treatment was made in patients with an insufficient ovarian response on the basis of effectiveness analysis, cost analysis, cost-effectiveness analysis, budget impact analysis, and sensitivity analysis. The compared alternatives were follitropin-alpha + lutropin-alpha/ recombinant follicle-stimulating hormone (rFSH) + recombinant luteinizing hormone (rLH), follitropin-alpha/ rFSH, and menotropin/human menopausal gonadotropin (hMG). Conclusion. The results of pharmacoeconomic analysis have shown that follitropin-alpha + lutropin-alpha dominates in terms of cost-effectiveness analysis and leads to cost savings in the treatment of infertility in patients with a suboptimal ovarian response.

Full Text

Restricted Access

About the authors

Roza I. Yagudina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: yagudina@inbox.ru
Doctor of Philosophy, Professor, Head of the Department of Organization of Drug Provision and Pharmacoeconomics

Andrey Y. Kulikov

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: 7677041@mail.ru
Doctor of Economics, Professor of the Department of Organization of Drug Supply and Pharmacoeconomics

Vyacheslav A. Krylov

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: krylov@mail.ru
post-graduate student of the Department of Organization of Drug Supply and Pharmacoeconomics

References

  1. Zegers-Hochschild F., Adamson G.D., de Mouzon J., Ishihara O., Mansour R., Nygren K. et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology, 2009. Fertil. Steril. 2009; 92(5): 1520-4.
  2. Серов В.Н., Кира Е.Ф., ред. Гинекология. Руководство для врачей. М.: Литтерра; 2008: 778-80.
  3. Сидорова И.С., Овсянникова Т.В., Макаров И.О., ред. Амбулаторно-поликлиническая помощь. Практическое руководство для врачей. М.: МЕДпресс-информ; 2009: 591-603.
  4. Здравоохранение в России. 2001: Стат. сб./ Росстат. М.; 2001.
  5. Здравоохранение в России. 2013: Стат. сб./ Росстат. М.; 2013.
  6. Здравоохранение в России. 2017: Стат. сб./ Росстат. М.; 2017.
  7. Указ Президента РФ от 9 октября 2007 г. N. 1351 „Об утверждении Концепции демографической политики Российской Федерации на период до 2025 года” (с изменениями и дополнениями).
  8. Доклад Министра здравоохранения Российской Федерации Вероники Скворцовой в Государственной Думе в рамках «Правительственного часа».
  9. Корсак В.С., Смирнова А.А., Шурыгина О.В. РАРЧ Отчет регистра ВРТ за 2015 год. В. кн.: Материалы XXVII международной конференции РАРЧ «Репродуктивные технологии сегодня и завтра». г. Санкт-Петербург 6-9 сентября 2017 года. СПб.; 2017.
  10. Ferraretti A.P., La Marca A., Fauser B.C., Tarlatzis B.; ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum. Reprod. 2011; 26(7): 1616-24.
  11. Alviggi C., Andersen C.Y., Buehler K., Conforti A., De Placido G., Esteves S.C., Poseidon Group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number). A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil. Steril. 2016; 105(6): 1452-3.
  12. Bühler K.F., Fischer R. Recombinant human LH supplementation versus supplementation with urinary hCG-based LH activity during controlled ovarian stimulation in the long GnRH-agonist protocol: a matched case-control study. Gynecol. Endocrinol. 2012; 28(5): 345-50.
  13. Alviggi C., Clarizia R., Pettersson K., Mollo A., Humaidan P., Strina I. et al. Suboptimal response to GnRHa long protocol is associated with a common LH polymorphism. Reprod. Biomed. Online. 2009; 18: 9-14.
  14. Lehert P., Kolibianakis E.M., Venetis C.A., Schertz J., Saunders H., Arriagada P. Recombinant human follicle-stimulating hormone (r-hFSH) plus recombinant luteinizing hormone versus r-hFSH alone for ovarian stimulation during assisted reproductive technology: systematic review and meta-analysis. Reprod. Biol. Endocrinol. 2014, 12: 17.
  15. Ferraretti A.P., Gianaroli L., Magli M.C., DAngelo A., Farfalli V., Montanaro N. Exogenous luteinizing hormone in controlled ovarian hyperstimulation for assisted reproduction techniques. Fertil. Steril. 2004; 82(6): 1521-6.
  16. Carone D., Caropreso C., Vitti A., Chiappetta R. Efficacy of different gonadotropin combinations to support ovulation induction in WHO type I. anovulation infertility: clinical evidences of human recombinant FSH/human recombinant LH in a 2:1 ratio and highly purified human menopausal gonadotropin stimulation protocols. J. Endocrinol. Invest. 2012; 35(11): 996-1002.
  17. Данные Федеральной службы государственной статистики. (по состоянию на 26.04.2018)
  18. Sun W., Stegmann B.J., Henne W., Catherino W.H., Segars J.H. A new approach to ovarian reserve testing. Fertil. Steril. 2008; 90(6): 2196-202.
  19. Petraglia F., Serour G.I., Chapron C. The changing prevalence of infertility. Int. J. Gynaecol. Obstet. 2013; 123(Suppl. 2): S4-8
  20. Хабриев Р.У., Куликов А.Ю., Аринина Е.Е. Методологические основы фармакоэкономического анализа. М.: Медицина; 2011. 128с.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2018 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies