Skip to main content
SpringerLink
Log in

NEWS AROUND THE WORLD: Reflections on the Cost-Effectiveness of Recombinant FSH in Assisted Reproduction. The Clinician's Perspective

  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose: To analyze the relative cost-effectiveness of recombinant FSH (rFSH) and urinary FSH (uFSH) in assisted reproduction techniques (ART).

Methods: Calculation of the average cost-effectiveness ratio and the incremental cost-effectiveness ratio to compare costs and effects (pregnancy rates) of the two therapeutic options (rFSH and uFSH).

Results: Assuming that the cost of the procedure per ART cycle is between 100,000 pesetas (601 euro) and 150,000 pesetas (901.52 euro), and pricing the GnRH analogues used for pituitary suppression at 35,000 pesetas (210.3 euro), the cost-effectiveness ratio is better for rFSH than for uFSH, implying that the cost per pregnancy is lower when the recombinant preparation is used.

Conclusions: In ART, the use of rFSH is more cost-effective than uFSH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Balasch J, Gonzàlez-Merlo J: Las nuevas gonadotrofinas recombinantes: un avance terapéutico. Prog Obstet Ginecol 1996;39:245-247

    Google Scholar 

  2. Balasch J: Aplicaciones clínicas de las gonadotropinas recombinantes. Clin Invest Gin Obst 1998;25:337-349

    Google Scholar 

  3. de Mouzon J, Lancaster P: World Collaborative Report on in vitro fertilization-1993.XVthWorld Congress onFertility and Sterility, Montpellier, Sept 17-22, 1995

  4. Queenan JT, Veeck LL, Muasher SJ: Clinical and laboratory aspects of cryopreservation. Semin Reprod Endocrinol 1995;13:64-71

    Google Scholar 

  5. Out HJ, Mannaerts BMJL, Driessen SGAJ, Coelingh Bennink HJTC: Recombinant follicle stimulating hormone (rFSH; Puregon) in assisted reproduction: More oocytes, more pregnancies. Results from five comparative studies. Hum Reprod Update 1996;2:162-171

    Google Scholar 

  6. Aboulghar MA, Mansour RT, Serour GI, Amin YM, Sattar MA, El Attar E: Recombinant follicle-stimulating hormone in the treatment of patients with history of severe ovarian hyperstimulation syndrome. Fertil Steril 1996;66:757-760

    Google Scholar 

  7. Sacristán JA, Badía X, Rovira J: Farmacoeconomía: Evaluación Económica de Medicamentos. Madrid, EditoresMédicos SA, 1995

    Google Scholar 

  8. Drummond MF, Stoddart GL, Torrance GW: Methods for the Economic Evaluation of Health Care Programmes. Oxford, Oxford University Press, 1987

    Google Scholar 

  9. Li TC, Hindle JE: Adverse local reaction to intramuscular injections of urinary-derived gonadotrophins. Hum Reprod 1993;8:1835-1836

    Google Scholar 

  10. Biffoni M, Battaglia A, Borrelli F, Cantelmo A, Galli G, Eshkol A: Allergenic potential of gonadotrophic preparations in experimental animals: Relevance of purity. Hum Reprod 1994;9:1845-1848

    Google Scholar 

  11. Harika G, Gabriel R, Quereux C, Wahl P, Lavaud F: Hypersensitization to human menopausal gonadotrophins with anaphylactic shock syndrome during a fifth in vitro fertilization cycle. J Assist Reprod Genet 1994;11:51-54

    Google Scholar 

  12. Redfearn A, Hughes EG, OÿConnor M, Dolovich J: Delayed type hypersensitivity to human gonadotropin: Case report. Fertil Steril 1995;64:855-856

    Google Scholar 

  13. Phipps WR, Holden D, Sheehan RK: Use of recombinant human follicle-stimulating hormone for in vitro fertilizationembryo transfer after severe systemic immunoglobulin Emediated reaction to urofollitropin. Fertil Steril 1996;66:148-150

    Google Scholar 

  14. Albano C, Smitz J, Camus M, Coelingh Bennink H, Van Steirteghem AC, Devroey P: Pregnancy and birth in an in-vitro fertilization cycle after controlled ovarian stimulation in a woman with a history of allergic reactions to human menopausal gonadotrophin. Hum Reprod 1996;11:1632-1634

    Google Scholar 

  15. Rodgers M, McLoughlin JD, Lambert A, Robertson WR, Mitchell R: Variability in the immunoactive and bioactive follicle stimulating hormone contents of human urinary menopausal gonadotrophin preparations. Hum Reprod 1995;10:1982-1986

    Google Scholar 

  16. Fauser BCJM, Van Heusden AMV: Manipulation of human ovarian function: Physiological concepts and clinical consequences. Endocr Rev 1997;18:71-106

    Google Scholar 

  17. Balasch J, Fábregues F, Peñarrubia J, Creus M, Vidal R, Casamitjana R, Manau D, Vanrell JA: Follicular development and hormonal levels following highly purified or recombinant follicle-stimulating hormone administration in ovulatory women and WHO group II anovulatory infertile patients. J Assist Reprod Genet 1998;15:552-559

    Google Scholar 

  18. Coeling-Bennink HJT, Fauser BCJM, Out HJ: Recombinant follicle-stimulating hormone (FSH; Puregon) is more efficient than urinary FSH (Metrodin) in women with clomiphene citrate-resistant, normogonadotropic, chronic anovulation: A prospective, multicenter, assessor-blind, randomized, clinical trial. Fertil Steril 1998;69:19-25

    Google Scholar 

  19. Hugues JN, Cedrin-Durnerin I, Bstandig B, Blasquez M, Hervé F, Uzan M: Comparison of recombinant and urinary follicle stimlating hormone preparations efficiency for achievement of follicular selection in patients with chronic anovulation (World Health Organization group II). Hum Reprod 1999;14(abstract book 1):127-128

    Google Scholar 

  20. Alonso Zafra J, de la Fuente Bitaine L, Ruiz Balda JA, Gosalvez Vega A, Iribarne Sanchez C, de la Fuente P: Use of new recombinant gonadotropin, recombinant folliclestimulating hormone, in assisted reproduction: A review. Assist Reprod 1999;9:180-184

    Google Scholar 

  21. Prien SD, Johnson D, Doan D: Comparison of commercially available first-, second-, and third-generation gonadotropins: From crude urinary proteins to biotechnology. Assist Reprod 1999;9:185-191

    Google Scholar 

  22. Matorras R, Recio V, Corcostegui B, Rodriguez-Escudero F: Recombinant human FSH versus highly purified urinary FSH: A randomized study in intrauterine insemination with husbands' spermatozoa. Hum Reprod 2000;15:1231-1234

    Google Scholar 

  23. Alonso-Zafra J, Iribarne C, Granda-Gorrochano J, Ruiz-Balda JA, de la Fuente P: Comparison of ovulation induction with recombinant FSH (recFSH) and highly purified urinary FSH (FSH HP) in intrauterine insemination cycles (IUI). Fertil Steril 1998;70(Suppl 1):S143

    Google Scholar 

  24. Raga F, Bonilla-Musoles F, Casañ EM, Bonilla F: Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and estradiol: improved reproductive outcome. Hum Reprod 1999;14:1431-1434

    Google Scholar 

  25. De Placido G, Alviggi C, Mollo A, Strina I, Varrichio MT, Molis M: Recombinant follicle stimulating hormone is effective in poor responders to highly purified follicle stimulating hormone. Hum Reprod 2000;15:17-20

    Google Scholar 

  26. Balasch J, Fábregues F, Creus M, Peñarrubia J, Vidal E, Carmona F, Puerto B, Vanrell JA: Follicular development and hormonal levels following highly purified or recombinant follicle-stimulating hormone administration in ovulatory women undergoing ovarian stimulation under pituitary suppression for in vitro fertilization: Implications for implantation potential. J Assist Reprod Genet 2000;17:20-27

    Google Scholar 

  27. FIVNAT 99: Dossier FIVNAT, Bilan de l'annee 98, 1999

  28. Wikland M: Progress of ART; The role of the clinician. Data presented at the 11thWorld Congress on In Vitro Fertilization and Human Reproductive Genetics, Sydney, May 1999 Journal of Assisted Reproduction and Genetics, Vol. 18, No. 2, 2001

  29. Philips Z, Barraza-Llorens M, Posnett J: Evaluation of the relative cost-effectiveness of treatments for infertility in the UK. Hum Reprod 2000;15:95-106

    Google Scholar 

  30. Goverde AJ, McDonnell J, Wermeiden JPW, Schats R, Rutten FFH, Schoemaker J: Intrauterine insemination or in-vitro fertilisation in idiopathic subfertility and male subfertility: A randomised trial and cost-effectiveness analysis. Lancet 2000;355:13-18

    Google Scholar 

  31. Templeton A, Morris JK: Reducing the risk of multiple births by transfer of two embryos after in vitro fertilization. N Engl J Med 1998;339:573-577

    Google Scholar 

  32. Schieve LA, Peterson HB, Meikle SF, Jeng G, Danel I, Burnett NM, Wilcox LS: Live-birth rates and multiplebirth risk using in vitro fertilization. JAMA 1999;282:1832-1838

    Google Scholar 

  33. Neumann PJ, Gharib SD, Weinstein MC: The cost of a successful delivery with in vitro fertilization. N Engl J Med 1994;331:239-243

    Google Scholar 

  34. Trad FS, Hornstein MD, Barbieri RL: In vitro fertilization: A cost-effective alternative for infertile couples? J Assist Reprod Genet 1995;12:418-421

    Google Scholar 

  35. Mor-Yosef S: Cost effectiveness of in vitro fertilization. J Assist Reprod Genet 1995;12:524-530

    Google Scholar 

  36. Out HJ, Driessen SGAJ, Mannaerts BMJL, Coelingh Bennink HJT: Recombinant follicle-stimulating hormone (follitropin beta, Puregon*) yields higher pregnancy rates in in vitro fertilization than urinary gonadotropins. Fertil Steril 1997;68:138-142

    Google Scholar 

  37. Manassiev NA, Tenekedjier KI, Collins J: Does the use of recombinant follicle-stimulating hormone instead of urinary follicle-stimulating hormone led to higher pregnancy rates in in vitro fertilization-embryo transfer cycles? Assist Reprod 1999;9:7-12

    Google Scholar 

  38. Daya S, Gunby J: Recombinant versus urinary follicle stimulating hormone for ovarian stimulation is assisted reproduction. Hum Reprod 1999;14:2207-2215

    Google Scholar 

  39. Larizgoitia I, Estrada MD, García-Altés A: FSH-recombinante como adyuvante en la reproducción asistida. Datos sobre eficacia y eficiencia de la FSH recombinante en relación con la FSH de origen urinario. Barcelona, Agència d'Avaluació de Tecnologia Mèdica, Servei Catalá de la Salut, Departament de Sanitat i Seguretat Social, Generalitat de Catalunya, Feb 2000

  40. Daya S, Gunby J: Recombinant versus urinary FSH for ovarian stimulation in assisted reproduction. Hum Reprod 2000;15:1208-1209

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut Clínic of Gynecology, Obstetrics and Neonatology, Faculty of Medicine—, University of Barcelona, Hospital Clínic—Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Juan Balasch

  2. Institut Universitari Dexeus, Barcelona, Spain

    Pedro N. Barri

Authors
  1. Juan Balasch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pedro N. Barri
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Balasch, J., Barri, P.N. NEWS AROUND THE WORLD: Reflections on the Cost-Effectiveness of Recombinant FSH in Assisted Reproduction. The Clinician's Perspective. J Assist Reprod Genet 18, 45–55 (2001). https://doi.org/10.1023/A:1026501821849

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026501821849

Search

Navigation