An Economic Analysis of Aneuploidy Screening of Oocytes in Assisted Reproduction in Germany

Kay Neumann, Georg Griesinger*

*Korrespondierende/r Autor/-in für diese Arbeit
3 Zitate (Scopus)

Abstract

Background The randomized ESTEEM trial reported that preimplantation genetic aneuploidy testing of oocytes by polar body biopsy (PGT-A) with array comparative genomic hybridization (aCGH) in women aged 36 - 40 years undergoing assisted reproduction treatment reduces the number of embryo transfers and the risk of miscarriage while not impacting the live birth rate. Method A decision tree model based on data from the ESTEEM trial was created and analyzed, using three cost scenarios for assisted reproduction treatment in Germany (statutory health insurance [GKV] = the deductible is 50% of the standard medical costs; private medical insurance [PKV] = invoicing is based on the German medical fee schedule [GOÄ]; private medical insurance with a simple GOÄ factor [simple GOÄ factor] = invoicing is based on the standard medical fees multiplied by a linear GOÄ factor). The scenarios were compared for cost-effectiveness (cost per live birth), cost per prevented miscarriage and the threshold values for cost and effectiveness. Results PGT-A increased the costs per live birth in all scenarios (GKV: + 208%; PKV: + 49%; simple GOÄ factor: + 89%). A threshold analysis showed a substantial cost discrepancy between the actual cost of the intervention based on GOÄ (€ 5801) vs. the theoretically tolerable PGT-A cost (GKV: € 561, PKV: € 1037, single GOÄ-factor: € 743). The incremental cost per one prevented miscarriage was approximately € 70 000 - 75 000 for all cost scenarios. Conclusion The use of PGT-A with aCGH in assisted reproduction cannot be recommended from a cost-effectiveness perspective.

OriginalspracheEnglisch
ZeitschriftGeburtshilfe und Frauenheilkunde
Jahrgang80
Ausgabenummer2
Seiten (von - bis)172-178
Seitenumfang7
ISSN0016-5751
DOIs
PublikationsstatusVeröffentlicht - 21.02.2020

Strategische Forschungsbereiche und Zentren

  • Zentren: Zentrum für Präimplantationsdiagnostik (PID)

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