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Is IVF good value for money? Why funding of assisted reproduction is sound fiscal policy
Date:6/8/2010

tely influence the multiple birth rate and infant outcomes. Although the poorer clinical outcomes are well known, the indirect costs and hence the economic burden associated with MAR multiple birth children - which may extend well beyond the perinatal period - are less appreciated.

Lack of affordable treatment may force patients and clinicians to opt for cheaper fertility treatments such as stimulated intrauterine insemination and ovulation stimulation which have less controllable means of minimising multiple births. If treatment is appropriately funded, there is less of a financial incentive to achieve pregnancy in a limited number of cycles.

Additionally, restricted treatment and limited financial access coerces some patients to seek cross border reproductive treatment in countries where cheaper or less restrictive treatments are offered. The ESHRE Task Force on 'Cross Border Reproductive Care' showed in a recent survey that, of those patients that sought cross border reproductive care, only 13% received partial reimbursement and 4% total reimbursement in their own country. Different standards of care and less responsible embryo transfer practices are amongst the risks patients' face when going abroad [2].

Public funding of MAR ranges from virtually no subsidisation in the US to funding of a limited number of cycles based on female age in most European countries. Many politicians have justified limited funding with the view that infertility is a socially constructed need rather than a medical disorder. 'The few studies we found on financial access to treatment suggest that affordability is a powerful determinant of whether couples will pursue treatment,' recalls Dr. Connolly. The cost (as percentage of an individual's annual disposable income) of a single fresh MAR cycle can range from 50% in the US to 20% in the UK and the Nordic countries. After government subsidies the costs in the US remained unchanged, but fell to 12% in the UK a
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Contact: Hanna Hanssen
hanna@eshre.eu
322-269-0969
European Society of Human Reproduction and Embryology
Source:Eurekalert

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