Table I.
Unit costs for the intervention, infertility treatments and complications.
| Cost parameter | Unit costs (€)a | Source |
|---|---|---|
| Healthcare costs | ||
|
| ||
| Endometrial scratchb | 104.00 | Calculated estimatec |
| Materials | 10.77 | |
| Gynaecologist/fertility physician | 26.75 | |
| Other costs regarding medical staff | 50.87 | |
| General costs of outpatient clinic visit | 15.61 | |
| Treatment costsd | ||
| IVF/ICSI stimulation only | 532.64 | Dutch expert panel |
| IVF/ICSI stimulation and OPU, no lab-phase | 1296.62 | Dutch expert panel |
| IVF stimulation, OPU, lab-phase, with or without embryo transfer | 1449.73 | Dutch expert panel |
| ICSI stimulation, OPU, lab-phase, with or without embryo transfer | 1803.49 | Dutch expert panel |
| Frozen–thaw embryo transfer cycle | 585.15 | Dutch expert panel |
| Medication costs | ||
| FSH analogues (€/IU) | 0.34 | Farmacotherapeutisch kompas |
| GnRH antagonist (€/day) | 39.30 | Farmacotherapeutisch kompas |
| GnRH agonist (€/day) | 10.99 | Farmacotherapeutisch kompas |
| Ovulation trigger (€/10 000 IU) | 2.47 | Farmacotherapeutisch kompas |
| Progesterone (€/200 mg) | 0.21 | Farmacotherapeutisch kompas |
| Complicationse | ||
| Mild OHSSf | 200.29 | Dutch expert panel (Van Tilborg et al., 2017) |
| Severe OHSSg | 2847.95 | Dutch expert panel |
|
| ||
| Societal costs | ||
|
| ||
| Lost productivity costs | ||
| Female (€/h) | 32.68 | CBS |
| Male (€/h) | 39.20 | CBS |
IU, international unit; mg, milligram; OHSS, ovarian hyperstimulation syndrome; OPU, oocyte pick-up.
Calculated for the year 2018.
Based on a 15 min outpatient clinic visit, without analgesia.
Costs of a single scratch were estimated based on the average time and medical equipment needed for a scratch. Costs for placement of an intrauterine device (without the product costs), a regular ultrasound, and costs of an endometrial biopsy catheter contributed to determining the estimate.
The costs include a counselling consultation, ultrasound scans, OPU, laboratory phase and embryo transfer. The laboratory phase includes fertilization through IVF or ICSI, and selection, cryopreservation and thawing of embryos.
The costs include clinic visits, telephone consultations, laboratory diagnostics and ultrasound scans. For severe OHSS, also costs for hospitalization are included.
Mild OHSS was defined as clinical symptoms and hospital check-ups but no hospitalization.
Severe OHSS was defined as the need for hospitalization.
Farmacotherapeutisch kompas: Dutch formulary for medication (Zorginstituut Nederland).
CBS: Netherlands statistics, the national statistical office (Hakkaart-van Roijen et al., 2015; StatLine (Centraal Bureau voor Statistiek)).
Dutch expert panel: expert panel on cost-effectiveness established by the Dutch Consortium for Research in Women’s Health. This panel consists of gynaecologists, economists and a methodologist and determined the average unit costs based on other fertility studies and actual costs of two university hospitals and a general hospital in the Netherlands.