A cost-effectiveness analysis of the use of highly purified human menopausal gonadotropins in assisted reproductive technology programs in gonadotropinreleasing hormone agonist or antagonist protocols

Abstract

Introduction. A comparative analysis of urinary and recombinant gonadotropins is relevant for the enhancement of the effectiveness of assisted reproductive technologies (ART) programs. Of particular interest is the analysis of the pharmacoeconomic efficiency of highly purified human menopausal gonadotropins (HMG) and the identification of individual groups of patients for whom the use of these drugs for ovarian stimulation in the ART program is most feasible and economically justified.Aim. To conduct a cost-effectiveness analysis of the use of Menopur Multidose at a dosage of 1200 IU for ovarian function stimulation in the standard ART protocols with gonadotropin-releasing hormone agonists and antagonists (GnRH-a and GnRH-ant).Materials and methods. The retrospective study included 4080 women aged 20 to 43 years. Stimulation of ovarian function in the ART program was carried out according to the GnRH antagonist protocol in 65.8% of patients and according to the GnRH-a protocol using Menopur Multidose at a dosage of 1200 IU supplemented with Menopur at a dosage of 75 IU used for its indications in 34.2% of women.Results and discussion. The clinical and laboratory data of the patients, stimulated cycle parameters, characteristics of the embryological stage, and the results of the ART program were analysed. The characteristics of the embryological stage met the KPI criteria, reflecting the key performance indicators of the embryology laboratory. Pharmacoeconomic analysis showed high involvement and adherence of patients to the treatment. In addition, it was found that the use of HMG makes efficient use of the budget within the average compulsory health insurance (CHI) tariff and accounts for 12% of the total tariff.Conclusion. Prescription of highly purified HMG (Menopur Multidose 1200 IU) to stimulate ovarian function in patients of different ages is accompanied by an adequate number of mature oocytes, good quality blastocysts, as well as satisfactory indicators of clinical pregnancy. A cost-effectiveness analysis of the use of Menopur Multidose at a dosage of 1200 IU showed that the prescription of this drug is clinically justified and economically feasible in patients of different age groups.