Abstract
BackgroundDuring in vitro fertilization (IVF), fertility patients are expected to self-administer many injections as part of this treatment. While newer medications have been developed to substantially reduce the number of these injections, such agents are typically much more expensive. Considering these differences in both cost and number of injections, this study compared patient preferences between GnRH-agonist and GnRH-antagonist based protocols in IVF.MethodsData were collected by voluntary, anonymous questionnaire at first consultation appointment. Patient opinion concerning total number of s.c. injections as a function of non-reimbursed patient cost associated with GnRH-agonist [A] and GnRH-antagonist [B] protocols in IVF was studied.ResultsCompleted questionnaires (n = 71) revealed a mean +/− SD patient age of 34 +/− 4.1 yrs. Most (83.1%) had no prior IVF experience; 2.8% reported another medical condition requiring self-administration of subcutaneous medication(s). When out-of-pocket cost for [A] and [B] were identical, preference for [B] was registered by 50.7% patients. The tendency to favor protocol [B] was weaker among patients with a health occupation. Estimated patient costs for [A] and [B] were $259.82 +/− 11.75 and $654.55 +/− 106.34, respectively (p < 0.005). Measured patient preference for [B] diminished as the cost difference increased.ConclusionsThis investigation found consistently higher non-reimbursed direct medication costs for GnRH-antagonist IVF vs. GnRH-agonist IVF protocols. A conditional preference to minimize downregulation (using GnRH-antagonist) was noted among some, but not all, IVF patient sub-groups. Compared to IVF patients with a health occupation, the preference for GnRH-antagonist was weaker than for other patients. While reducing total number of injections by using GnRH-antagonist is a desirable goal, it appears this advantage is not perceived equally by all IVF patients and its utility is likely discounted heavily by patients when nonreimbursed medication costs reach a critical level.
Highlights
During in vitro fertilization (IVF), fertility patients are expected to self-administer many injections as part of this treatment
While it seems intuitive that the avoidance of unnecessary injections would appeal to IVF patients, it has never been established if this preference is conserved even when extra ‘out-of-pocket’ costs are encountered
Is the desire to reduce the number of subcutaneous injections in IVF sufficiently strong that the financial cost associated with GnRHantagonists is irrelevant? To explore this issue, our study sought to characterize IVF patient opinion on the matter of non-reimbursed medication costs associated with either a GnRH-agonist or GnRH-antagonist protocols
Summary
During in vitro fertilization (IVF), fertility patients are expected to self-administer many injections as part of this treatment. While newer medications have been developed to substantially reduce the number of these injections, such agents are typically much more expensive. Considering these differences in both cost and number of injections, this study compared patient preferences between GnRH-agonist and GnRH-antagonist based protocols in IVF. Because medications are relatively costly and may account for more than half of the overall IVF treatment expense [6], the ‘outof-pocket’ costs of particular agents have special relevance for fertility patients. Our study sought to characterize IVF patient opinion on the matter of non-reimbursed medication costs associated with either a GnRH-agonist or GnRH-antagonist protocols Is the desire to reduce the number of subcutaneous injections in IVF sufficiently strong that the financial cost associated with GnRHantagonists is irrelevant? To explore this issue, our study sought to characterize IVF patient opinion on the matter of non-reimbursed medication costs associated with either a GnRH-agonist or GnRH-antagonist protocols
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