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In Vitro Fertilization with Preimplantation Genetic Testing for Aneuploidy for Infertility in China: A Cost-Effectiveness Analysis
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  • xuan he,
  • Xiao Wang,
  • Jiaojie Shen,
  • Bin Wan,
  • Yingpeng Wang,
  • Zhuolin Zhang,
  • Lele Cai,
  • Yuwen Bao,
  • Haixia Ding,
  • Xin Li
xuan he
Nanjing Medical University

Corresponding Author:[email protected]

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Xiao Wang
Nanjing Medical University
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Jiaojie Shen
Nanjing Medical University
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Bin Wan
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
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Yingpeng Wang
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
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Zhuolin Zhang
Nanjing Medical University
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Lele Cai
Nanjing Medical University
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Yuwen Bao
Nanjing Medical University
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Haixia Ding
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
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Xin Li
Nanjing Medical University
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Abstract

Objectives: To investigate the cost-effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) versus conventional technology in in vitro fertilization (IVF) from the perspective of the healthcare system in China. Design: Economic evaluation based on a large multi-center randomized trial (CESE-PGS study). Population: Infertile women with a good prognosis for a live birth in China Methods: Following the exact steps in the IVF protocol, a decision tree model was developed, based on the data from the CESE-PGS trial and using cost scenarios for IVF in China. The scenarios were compared for costs per patient and cost-effectiveness. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to confirm the robustness of the findings. Main Outcome Measures: Costs per live birth, Costs per patient, Incremental cost-effectiveness for miscarriage prevention Results: The average costs per live birth of PGT-A were estimated as ¥39230.71, which is about 16.8% higher than that of the conventional group. Threshold analysis revealed that PGT-A would need to increase the pregnancy rate of 26.24% to 98.24% or a cost reduction of ¥4649.29 to ¥1350.71 to achieve the same cost-effectiveness. The incremental costs per prevented miscarriage was approximately ¥45600.23. Probabilistic sensitivity analysis indicated a probability of 97.50% that PGT-A is cost-effective when the willingness to pay was ¥ 21,7113.00 per prevented miscarriage. Conclusions: The present cost-effectiveness analysis demonstrates that embryo selection with PGT‑A is not suitable for routine applications from the perspective of healthcare providers in China, given the cumulative live birth rate (CLBR) and the high costs of PGT‑A.
06 Jun 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
08 Jun 2022Submission Checks Completed
08 Jun 2022Assigned to Editor
16 Jun 2022Reviewer(s) Assigned
01 Jul 2022Review(s) Completed, Editorial Evaluation Pending