Cost-Effectiveness of Follitropin Delta Compared with Follitropins Alfa and Beta in Controlled Ovarian Stimulation...

Follitropin delta, using a personalized dosing regimen, is an effective treatment option for women undergoing controlled ovarian stimulation (COS) for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

The aim of this study was to develop a model to determine cost effectiveness of follitropin delta compared with follitropins alfa and beta for women undergoing IVF/ICSI in France.

A decision-tree model was developed comparing the outcomes of treatment with follitropin delta versus other follitropins through ongoing pregnancy (OP) and live birth (LB) rates in fresh cycles. Pooled data from the pivotal clinical trials ESTHER (EU + rest of world; NCT01956110), GRAPE (Pan-Asia; NCT03296527), and STORK (Japan; NCT03228680) was used for the economic model. The analyses were stratified by age and ovarian reserve profile and reflected a single COS cycle. Costs were estimated from the healthcare perspective in France, and uncertainty was assessed through sensitivity analyses.

In women with an elevated anti-Müllerian hormone level (≥15 pmol/L), follitropin delta achieved a higher rate of LB (31.4% vs 25.8%, p = 0.01) and a numerically higher rate of OP (35.7% vs 31.6%) compared with follitropins alfa/beta. Additionally, treatment with follitropin delta was associated with numerically fewer miscarriages (4.3% vs 5.8%) and lower ovarian hyperstimulation syndrome (OHSS) incidence (8.2% vs 11.5%). Total treatment cycle cost with/without delivery cost was €5479/€4099 for follitropin delta, €5335/€4191 for follitropin alfa, and €5387/€4243 for follitropin beta. The incremental cost-effectiveness ratio was €2579/LB for follitropin delta versus follitropin alfa. Follitropin beta was shown to be less efficient, and more costly (i.e. dominated). Excluding the delivery cost, follitropin delta was more efficient and less costly (i.e. dominant) versus other follitropins. Probabilistic sensitivity analyses supported the deterministic results, showing > 76% probability of follitropin delta being dominant when assessing cost per additional OP. Similar results were observed in the overall population of women.

Follitropin delta provides an effective alternative to follitropin alfa and beta with a potential cost-savings opportunity, excluding the delivery cost, due to higher OP and LB rates in the fresh cycle transfers.