Journal
JOURNAL OF ASSISTED REPRODUCTION AND GENETICS
Volume 40, Issue 4, Pages 793-801Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10815-023-02738-7
Keywords
Cost-effectiveness; IVF; PGTM; PGTA; Spinal muscular atrophy
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This study evaluated the cost-effectiveness of in-vitro fertilization with preimplantation genetic testing to prevent transmission of spinal muscular atrophy to offspring of carrier couples. The results showed that IVF with PGT-M/A is cost-effective compared to unassisted conception in preventing the transmission of spinal muscular atrophy.
Purpose To evaluate the cost-effectiveness of in-vitro fertilization with preimplantation genetic testing for aneuploidy and monogenic disorders (IVF with PGT-M/A) to prevent transmission of spinal muscular atrophy to offspring of carrier couples. Methods A decision-analytic model was created to compare the cost-effectiveness of IVF with PGT-M/A to unassisted conception with prenatal diagnostic testing and termination (if applicable). IVF with PGT-M/A costs were determined using a separate Markov state- transition model. IVF outcomes data was derived from 76 carriers of monogenic disorders who underwent IVF with PGT-M/A at a single academic REI center. Other probabilities, costs, and utilities were derived from the literature. Costs were modeled from healthcare perspective. Utilities were modeled from the parental perspective as quality-adjusted life-years (QALYs). Results The incremental cost-effectiveness ratio for IVF with PGT-M/A compared to unassisted conception is $22,050 per quality-adjusted life-year. The average cost of IVF with PGT-M/A is $41,002 (SD: $8,355). At willingness-to-pay thresholds of $50,000 and $100,000, IVF with PGT-M/A is cost-effective 93.3% and 99.5% of the time, respectively. Conclusions Compared to unassisted conception, IVF with PGT-M/A is cost-effective for preventing the transmission of spinal muscular atrophy to the offspring of carrier couples. These findings support insurance coverage of IVF with PGT-M/A for carriers of spinal muscular atrophy.
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