Abstract
Purpose
To estimate the incremental cost effectiveness of ICSI, and total costs for the population of Australia.
Methods
Treatment effects for three patient groups were drawn from a published systematic review and meta-analysis of trials comparing fertilisation outcomes for ICSI. Incremental costs derived from resource-based costing of ICSI and existing practice comparators for each patient group.
Results
Incremental cost per live birth for patients unsuited to IVF is estimated between A$8,500 and 13,400. For the subnormal semen indication, cost per live birth could be as low as A$3,600, but in the worst case scenario, there would just be additional incremental costs of A$600 per procedure. Multiplying out the additional costs of ICSI over the relevant target populations in Australia gives potential total financial implications of over A$31 million per annum.
Conclusion
While there are additional benefits from ICSI procedure, particularly for those with subnormal sperm, the additional cost for the health care system is substantial.
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Notes
The Australian Medical Benefits Schedule fees are the basis of the public subsidy for medical services based on an estimate of the cost of the service. The actual fee charged may be in excess of that level.
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Capsule ICSI appears highly cost-effective for some categories of patient but may increase costs and provide no additional benefits for other indications.
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Hollingsworth, B., Harris, A. & Mortimer, D. The cost effectiveness of intracyctoplasmic sperm injection (ICSI). J Assist Reprod Genet 24, 571–577 (2007). https://doi.org/10.1007/s10815-007-9175-0
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DOI: https://doi.org/10.1007/s10815-007-9175-0