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Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model

Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model,Audrey A. A. Fiddelers,Carmen D. Dirksen,John C. M. Dumoulin,A

Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model   (Citations: 1)
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background: A selective switch to elective single embryo transfer (eSET) in IVF has been suggested to prevent complications of fer- tility treatment for both mother and infants. We compared seven IVF strategies concerning their cost-effectiveness using a Markov model. methods: The model was based on a three IVF-attempts time horizon and a societal perspective using real world strategies and data, comparing seven IVF strategies, concerning costs, live births and incremental cost-effectiveness ratios (ICERs). results: In order to increase pregnancy probability, one cycle of eSET þ one cycle of standard treatment policy (STP, i.e. eSET in patients ,38 years of age with at least one good quality embryo and double embryo transfer (DET) in the remainder of patients) þ one cycle of DET have an ICER of E16 593 compared with three cycles of eSET. Furthermore, three STP cycles have an ICER of E17 636 com- pared with one cycle of eSET þ one cycle of STP þ one cycle of DET, and three DET cycles have an ICER of E26 729 compared with three cycles STP. conclusions: Our study shows that in patients qualifying for IVF treatment, combining several transfer policies was not cost-effective. A choice has to be made between three cycles of eSET, STP or DET. It depends, however, on society's willingness to pay which strategy is to be preferred from a cost-effectiveness point of view.
Published in 2009.
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    • ...The conclusions of the review are confirmed by a detailed (cost-)effectiveness analysis [20,26] and a Markov costeffectiveness model [32]...
    • ...These results will be linked to a Markov model in which seven embryo transfer strategies are compared [32], to enable estimation of the long-term cost-effectiveness of SET strategies versus DET strategies...
    • ...Short and long-term cost-effectiveness of SET strategies versus DET strategies The TwinSing model will be linked to a short-term Markov model developed at the University Hospital Maastricht [32], that compared seven embryo transfer strategies varying from three cycles SET to three cycles DET and several combination strategies...
    • ...As twins are more common among woman receiving DET, including the QALYs of both twin children in the costeffectiveness analysis will have considerable impact on the ICERs [32]...

    Mirjam MJ van Heeschet al. Long term costs and effects of reducing the number of twin pregnancies...

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