Cost-effectiveness study of clomiphene citrate versus anastrozole for inducing ovulation in infertile adult patients in a public hospital, La Raza in Mexico City

被引:0
作者
Martinez Nunez, Juan Manuel [1 ]
Altagracia Martinez, Marina [1 ]
Rios, Camilo [1 ,2 ]
Kravzov Jinich, Jaime [1 ]
Hinojosa Cruz, Juan Carlos [3 ]
Vital Reyes, Victor Saul [3 ]
机构
[1] Univ Autonoma Metropolitana Campus Xochimilco UAM, Dept Sistemas Biol, Mexico City, DF, Mexico
[2] INNN, Mexico City, DF, Mexico
[3] IMSS, Hosp Ginecoobstet 3, Ctr Med Nacl La Raza, Mexico City, DF, Mexico
关键词
anastrozole; anovulation; clomiphene citrate; cost-effectiveness; female infertility;
D O I
10.1111/j.1759-8893.2010.00027.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective To evaluate the cost-effectiveness (CE) ratio of clomiphene citrate versus anastrozole in the induction of ovulation in infertile adult women attending a Mexican public hospital. Methods ACE study was conducted from a hospital perspective. A clinical pilot study was carried out at the La Raza hospital. Thirty patients with infertility due to anovulation were recruited and grouped as follows: group A was treated with clomiphene citrate and group B with anastrozole. Efficacy data and adverse events of both drugs were obtained from the above-described clinical pilot study with Mexican women patients and through a systematic review of published medical literature. Efficacy data were analysed using meta-analysis; direct and indirect costs were gathered and calculated by the micro-costing technique, and a 1-year time horizon was considered. The Monte Carlo Markov model was used, and quality-adjusted life years (QALYs) were used as the unit of effectiveness. Incremental and sensitivity analyses were performed and we investigated the effect of a 5% discount rate. Key findings The odds ratios from the meta-analysis were 0.86 for ovulation induction and 1.46 for pregnancy. The most cost-effective therapy was clomiphene citrate at US$405/QALY in comparison to US$457/QALY for anastrozole. The incremental cost was US$52/QALY. The result of the discount rate for the most cost-effective therapy projected for 5 years was US$1288. The sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or the treatment costs were modified. Conclusion Conventional treatment with clomiphene citrate therapy has the highest cost-effectiveness for the population studied.
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页码:35 / 40
页数:6
相关论文
共 20 条
[1]  
[Anonymous], 1996, HUM REPROD, V11, P1779
[2]   Economic consequences of epidemiological changes in diabetes in middle-income countries -: The Mexican case [J].
Arredondo, A ;
Zúñiga, A .
DIABETES CARE, 2004, 27 (01) :104-109
[3]   RETRACTED: Anastrozole or letrozole for ovulation induction in clomiphene-resistant women with polycystic ovarian syndrome: a prospective randomized trial (Retracted Article) [J].
Badawy, Ahmed ;
Mosbah, Abeer ;
Shady, Magda .
FERTILITY AND STERILITY, 2008, 89 (05) :1209-1212
[4]   RETRACTION: Clomiphene citrate or anastrozole for ovulation induction in women with polycystic ovary syndrome? A prospective controlled trial' (Retraction of Vol 120, Pg 120, 2023) [J].
Badawy, Ahmed ;
Aal, Ibrahim Abdel ;
Abulatta, Mohamed .
FERTILITY AND STERILITY, 2023, 120 (02) :397-397
[5]  
Calderon-Garciduenas AL, 2000, SALUD PUBLICA MEXICO, V42, P26
[6]  
Collins JA, 1997, HUM REPROD, V12, P951
[7]   Ovulation induction management of PCOS [J].
Guzick, David S. .
CLINICAL OBSTETRICS AND GYNECOLOGY, 2007, 50 (01) :255-267
[8]  
Jose-Miller AB, 2007, AM FAM PHYSICIAN, V75, P849
[9]   REGIONAL AND GEOGRAPHICAL VARIATIONS IN INFERTILITY - EFFECTS OF ENVIRONMENTAL, CULTURAL, AND SOCIOECONOMIC-FACTORS [J].
LEKE, RJI ;
ODUMA, JA ;
BASSOLMAYAGOITIA, S ;
BACHA, AM ;
GRIGOR, KM .
ENVIRONMENTAL HEALTH PERSPECTIVES, 1993, 101 :73-80
[10]  
Muenning P., 2002, DESIGNING CONDUCTING