Mild Stimulation versus Conventional IVF: A Cost-Effectiveness Evaluation

Purpose: To compare the strategy for mild stimulation IVF versus conventional stimulation IVF. Methods: A decision tree analytic model was created to compare IVF with mild stimulation versus convention stimulation in infertile women <38 years of age to evaluate which strategy is the least costly per live birth. Results: Using base-case estimates of costs and probabilities in women <38 years old with unexplained infertility, the cumulative live birth rate in the mild versus conventional stimulation group was 15.8% versus 28.6%, respectively. The average cost for mild and convention IVF was $8789 and$14,364 per arm, respectively. In base case analysis, the ICER was $43,516 representing the additional cost per live birth with conventional IVF. One-way sensitivity analysis evaluated the robustness of the data and revealed a tradeoff in which mild IVF stimulation had lower total costs and also lower live births versus conventional stimulation. Conclusions: Mild stimulation IVF has a lower cost per cycle but is also associated with lower live birth rates. Patient care decisions should be individualized irrespective of cost

Race, Politics, and Health

“Remapping the Margins: The Necessity for an Intersectional Approach in Investigating Black Lesbians in the American South” Jayme N. Canty, Clark Atlanta University “Activist Bodies, Jewish Identities: Profiles of Jewish American Feminists in the Women’s Health Movement, 1968-Present” Jillian M. Hinderliter, University of South Carolina - Columbia “Revisiting Intersectionality: A Framework for Addressing Health Disparities among African American Women” Marcia Davis Taylor, University of South Carolina – Columbia “Deconstructing Urbanicity in Nigeria: Applying an Intersectional Lens to a Secondary Data Analysis of Family Planning Usage” Kashika Sahay, University of North Carolina at Chapel Hil

Labor Market Participation and Productivity Costs for Female Caregivers of Minor Male Children With Duchenne and Becker Muscular Dystrophies

Introduction/Aims Duchenne and Becker muscular dystrophies (DBMD) are X-linked neuromuscular disorders characterized by progressive muscle weakness, leading to decreased mobility and multisystem complications. We estimate productivity costs attributable to time spent by a parent caring for a male child under the age of 18 y with DBMD, with particular focus on female caregivers of boys with Duchenne muscular dystrophy (DMD) who have already lost ambulation. Methods Primary caregivers of males with DBMD in the Muscular Dystrophy Surveillance and Research Tracking Network (MD STARnet) were surveyed during 2011–2012 on family quality of life measures, including labor market outcomes. Of 211 respondents, 96 female caregivers of boys with DBMD were matched on state, year of survey, respondent\u27s age, child\u27s age, and number of minor children with controls constructed from Current Population Survey extracts. Regression analysis was used to estimate labor market outcomes and productivity costs. Results Caregivers of boys with DBMD worked 296 h less per year on average than caregivers of unaffected children, translating to a $8816 earnings loss in 2020 U.S. dollars. Caregivers of boys with DMD with ≥4 y of ambulation loss had a predicted loss in annualized earnings of$23,995, whereas caregivers of boys with DBMD of the same ages who remained ambulatory had no loss of earnings. Discussion Female caregivers of non-ambulatory boys with DMD face additional household budget constraints through income loss. Failure to include informal care costs in economic studies could understate the societal cost-effectiveness of strategies for managing DMD that might prolong ambulation