In Vitro Fertilization with Preimplantation Genetic Testing for
Aneuploidy for Infertility in China: A Cost-Effectiveness Analysis
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.