PRM33 - Methodology Using Pharmacy And Medical Claims Data To Evaluate Real-World Outcomes And Costs Of Ivf Treatment In The Us

Abstract

To describe the methodology used to identify treatment cycles and determine real-world outcomes associated with the in vitro fertilization (IVF) treatments, follicle-stimulating hormone (FSH) versus FSH+human menopausal gonadotropin (hMG), using administrative claims data. This retrospective study used the Truven Healthcare MarketScan® Claims Database to identify and compare IVF treatment protocols, pregnancy and birth outcomes among women aged 18–<35 undergoing IVF between January 2009 and December 2012. Patients with ≥1 claim for a gonadotropin-releasing hormone agonist (GnRHAg) or antagonist (GnRHAnt) (first claim being the index date), ≥1 claim for FSH and ≥1 claim for human chorionic gonadotropin (hCG), using National Drug Codes, were selected. Patients were included on identification of a prescription for FSH in the 7 days pre-index through 60 days post-index, hCG in the 60 days post-index and ≥1 embryo transfer (ET) code (using current procedural terminology) ≤60 days post-index. The FSH+hMG cohort also required identification of ≥1 claim for hMG ≤60 days post-index. Patient eligibility was defined as continuous enrollment for 12 months prior and 18 months post-index. ICD-9-CM codes were used to identify live birth outcomes within 42 weeks of ET. Inclusion/exclusion criteria identified 627 and 852 patients in the FSH and FSH+hMG cohorts, respectively. The 18-month post-index eligibility criteria accounted for a large number of patients removed (n=7366). No differences in first-cycle outcomes were seen between FSH and FSH+hMG for: live birth per ET (38.1% vs 38.5%; OR 1.02 [95%CI: 0.82–1.26], p=0.871) and live birth per pregnancy (54.44% vs 54.37%; OR 1.00 [95%CI: 0.78–1.28], p=0.98), respectively. Most published analyses of fertility treatment outcomes are derived from single fertility center datasets. This methodology successfully identified two distinct IVF treatment protocols and allowed comparison of outcomes using real-world healthcare claims data sourced from a variety of fertility centers.