P-725 Automated follicular tracking with three-dimensional ultrasound and SonoAVC saves costs: debunking myths

Abstract

Abstract Study question What is the incremental cost per patient and the budgetary impact of the SonoAVCTMfollicle technique compared to two-dimensional ultrasound in a private assisted reproduction center? Summary answer Our results support the implementation of follicular tracking with 3D ultrasound and SonoAVCTM from an economic point of view. What is known already Advantages of follicular tracking with 3D US and SonoAVC include increased precision and reproducibility, increased patient comfort, decreased ultrasonographer’s time and improved workflow. The main benefit of SonoAVC is that it allows quick measurements of follicular volume, which has been shown to be more precise than 2D diameters for estimation of follicular size. Until now, it has been assumed that 3D ultrasound represents an increase in costs, this being the main justification of professionals who refuse to implement it. Study design, size, duration Cost study and economic analysis. The costs associated with the adoption of the SonoAVC™follicle software and the 2D ultrasound were estimated as well as the cost of medical dedication time. Since the cost of the equipment represents an initial investment, we proceeded to annualize it. For the economic analysis we calculated a) cost for each patient included in the study and b) total annual cost for a private center to incorporate the SonoAVC™follicle program. Participants/materials, setting, methods Population: patients treated in our center in 2019 (N = 295). Budget impact analysis was performed from the perspective of a private assisted reproduction center with a 5-year time horizon. The analysis was adapted to three scenarios according to the size of the center: a private center with: a) 600 cycles/year including IVF/ICSI and oocyte donation b) 300 cycles/year and c) 100 cycles/year. Main results and the role of chance Equivalent annual cost of the ultrasound device and transvaginal probe after annualization was 3985.93 € for 2D and 4572.10 € for 3D. The corresponding cost per patient/cycle was 13,51€ for 2D and 15,50 € 3D. Medical dedication time cost was 5,6 € for 2D follicular monitoring and 3,3 € for 3D follicular monitoring. Total cost per patient/cycle for follicular monitoring, including hardware and medical dedication was 69,5€ for 2D and 48,5€ for 3D ultrasound. For the budget impact analysis, three different sizes of centers were considered: 600, 300 and 100 cycles/year. In all of them there was a saving with 3D ultrasound of 2101 €, 6303 € and 12606 € respectively. The net budgetary impact over 5 years, i.e., the difference between the current scenario (2D ultrasound) and the new scenario (3D ultrasound with SonoAVC™follicle) for a center with approximately 300 cycles/year, would be 31.515€. Therefore, the implementation of the new technique with SonoAVC™follicle would save costs. Limitations, reasons for caution In centers 600 cycles/year an extra ultrasound device may be included in the analysis. Wider implications of the findings Follicular monitoring with 3D ultrasound is cheaper than 2D ultrasound even in small centers and this saving is greater the larger the center is. Therefore, our results demonstrate that cost savings are another added advantage of follicular monitoring with 3D ultrasound and sonoAVC. Trial registration number not applicable