Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Is IVF good value for money? Why funding of assisted reproduction is sound fiscal policy

09.06.2010
Children conceived by Medically Assisted Reproduction (MAR) have fiscal implications for government both in terms of future government spending and tax revenue. Based on public funding to conceive a MAR child - after factoring in education, future health and pension costs, and future tax contributions of this child - the discounted net tax revenue (the difference between future government spending and tax revenue) of a child born in 2005 is roughly €127,000 in today’s value. Considering an average treatment cost of approximately €15,000 to conceive an IVF-child, this represents an 8-fold return on investment (ROI) for governments [1].

While the costs of MAR treatment represent a substantial proportion of a patient’s annual disposable income, MAR typically represents less than 0.25% of total national healthcare expenditure. By comparison, obesity accounts for 10% and 2-4% of total health care spending in the US and Europe respectively.

MAR treatments elicit significant medical, reproductive and economic influence in developed countries with 3.5 million children estimated to have been born worldwide since 1978. These children make up a substantial proportion of national births with up to 4.1% in Denmark and 3.3% in Belgium. In the US, Europe, and Oceania over 600,000 treatment cycles resulted in 120,000 children being born in 2005.

The European Society of Human Reproduction and Embryology (ESHRE) Task Force on ‘Reproduction and Society’ reviewed the economics of MAR to evaluate the benefits of funding of MAR for society and to inform policy makers on effective, safe and equitable financing of MAR. Dr. Mark Connolly and colleagues who published this review paper in the journal Human Reproduction Update based their findings on key epidemiological and economic studies.

Affordability of IVF is one of the main drivers of treatment utilisation, choice of treatment, and embryo transfer practices which ultimately 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 and in Scandinavia.

So far very few studies exist that have evaluated MAR children in terms of fiscal implications, and although an 8-fold ROI for any government is quite substantial, the ESHRE Task Force calls for caution ‘these results need to be applied in a policy framework and in the broad context of other governmental policies. The creation of a child leads to increased government expenses in the short-term, and the ROI in future taxes is not received until more than 30 years later once these children enter the workforce.’

The authors conclude that the way MAR is subsidised in different healthcare settings and for different patient groups has far-reaching consequences for access to treatment, clinical practice, and infant outcomes. MAR children deserve the best start in life, and as discussed in this review, affordable treatment can make economic sense as well.
[1] The costs and consequences of assisted reproductive technology: an economic perspective. Human Reproduction Update. doi:10.1093/humupd/dmq013. A pdf of the full paper can be downloaded here.

[2] Cross border reproductive care in six European countries. Shenfield F, et al., and the ESHRE Taskforce on Cross Border Reproductive Care. Human Reproduction doi:10.1093/humrep/deq057. A pdf of the full paper can be obtained here.

Please acknowledge Human Reproduction Update as a source in any articles. For more information please contact Hanna Hanssen, Communications Manager for ESHRE, Tel: + 32 (0)2 269 09 69, hanna@eshre.eu .

ESHRE was founded in 1985 with a mission is to promote the understanding of reproductive science and medicine. It does this through facilitating research and the dissemination of research findings in human reproduction and embryology to the general public, scientists, clinicians, patient associations and key policy makers across Europe. Human Reproduction and Human Reproduction Update are monthly journals of ESHRE, and are published by Oxford Journals, a division of Oxford University Press.

Hanna Hanssen | EurekAlert!
Further information:
http://www.eshre.eu

More articles from Life Sciences:

nachricht Researchers reveal new details on aged brain, Alzheimer's and dementia
21.11.2017 | Allen Institute

nachricht Nanoparticles help with malaria diagnosis – new rapid test in development
21.11.2017 | Fraunhofer-Institut für Silicatforschung ISC

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

From Hannover around the world and to the Mars: LZH delivers laser for ExoMars 2020

21.11.2017 | Physics and Astronomy

Borophene shines alone as 2-D plasmonic material

21.11.2017 | Materials Sciences

Penn study identifies new malaria parasites in wild bonobos

21.11.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>