Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 6, 2019
Open Peer Review Period: Mar 11, 2019 - May 6, 2019
Date Accepted: Jul 28, 2019
(closed for review but you can still tweet)
mHealth coaching on nutrition and lifestyle behaviors for subfertile couples using the Smarter Pregnancy program: a model-based cost-effectiveness analysis
ABSTRACT
Background:
The healthcare costs for reproductive care have substantially increased by the use of in vitro fertilization (IVF) treatment. The mHealth coaching program Smarter Pregnancy is an effective intervention to improve nutrition and lifestyle behaviors and pregnancy rates in (sub)fertile couples, including those who undergo IVF treatment. Therefore, we hypothesize that this mHealth program also reduces healthcare costs associated with IVF treatment.
Objective:
To evaluate the cost-effectiveness of the mHealth coaching program Smarter Pregnancy versus usual care in women of subfertile couples who start their first IVF cycle.
Methods:
This model-based cost-effectiveness analysis was performed on data from couples undergoing IVF treatment at the Erasmus MC, University Medical Center Rotterdam. A decision tree model was used to assess the incremental cost-effectiveness ratio (ICER) of ongoing pregnancies and costs of use of the mHealth program versus usual care. A probabilistic sensitivity analysis was performed to consider the uncertainty surrounding the point estimates of the input parameters.
Results:
Based on our model, including 793 subfertile women undergoing IVF treatment, the use of the mHealth program resulted in 86 additional pregnancies and saved €270,000 compared to usual care after two IVF cycles, with an ICER of -€3,050 (95%CI -3,960;-540) per additional pregnancy. The largest cost saving was caused by the avoided IVF treatment costs. Sensitivity analyses showed that the mHealth program needs to increase the ongoing pregnancy rate with at least 51% after two IVF cycles in order to be cost saving.
Conclusions:
The mHealth coaching program Smarter Pregnancy is potentially cost-saving for subfertile couples preceding their first IVF treatment. Implementation of this mHealth program in routine preconception care for subfertile couples should be seriously considered given the relatively low costs and promising cost-effectiveness estimates. Clinical Trial: Dutch Trial Registration: NTR1450
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.