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 Transport of molecular motors into cilia
28.03.2017 | Aarhus University

nachricht Asian dust providing key nutrients for California's giant sequoias
28.03.2017 | University of California - Riverside

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

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

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Transport of molecular motors into cilia

28.03.2017 | Life Sciences

A novel hybrid UAV that may change the way people operate drones

28.03.2017 | Information Technology

NASA spacecraft investigate clues in radiation belts

28.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>