Cost-Effectiveness of Recombinant Versus Urinary Follicle-Stimulating Hormone in Assisted Reproduction Techniques in the Spanish Public Health Care System

Purpose: To evaluate the relative cost-effectiveness of recombinant and urinary follicle-stimulating hormone (FSH) in assisted reproduction techniques in the Spanish National Health Service.Methods: Markov modelling was used to compare costs and outcomes of three complete treatment cycles using recombinant or urinary FSH for controlled ovarian stimulation. Cost and effectiveness estimates were obtained from the literature and from Spanish clinicians. A Monte Carlo technique was used to randomise the distribution of outcomes at each stage. The analysis was performed by passing a virtual population of 100,000 patients through the computer simulation in each of 5000 Monte Carlo simulations.Results: The cost per pregnancy was €12,791 ± 1202 ($11,346 ± 1066) with recombinant and €13,007 ± 1319 ($11,537 ± 1170) with urinary FSH (p < 0.0001). The mean number of cycles per pregnancy was 4.69 and 5.21, respectively.Conclusions: Recombinant FSH is more cost-effective than urinary FSH in the Spanish public health care system.