The economic impact of assisted reproductive technology: a review of selected developed countries

Chambers, GM; Sullivan, EA; Ishihara, O; Chapman, MG; Adamson, GD

The economic impact of assisted reproductive technology: a review of selected developed countries

Chambers, GM Sullivan, EA

Ishihara, O Chapman, MG Adamson, GD

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Publication Type:: Journal Article
Citation:: Fertility and Sterility, 2009, 91 (6), pp. 2281 - 2294
Issue Date:: 2009-06-01

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Field	Value	Language
dc.contributor.author	Chambers, GM	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.contributor.author	Ishihara, O	en_US
dc.contributor.author	Chapman, MG	en_US
dc.contributor.author	Adamson, GD	en_US
dc.date.available	2009-04-13	en_US
dc.date.issued	2009-06-01	en_US
dc.identifier.citation	Fertility and Sterility, 2009, 91 (6), pp. 2281 - 2294	en_US
dc.identifier.issn	0015-0282	en_US
dc.identifier.uri	http://hdl.handle.net/10453/29768
dc.description.abstract	Objective: To compare regulatory and economic aspects of assisted reproductive technologies (ART) in developed countries. Design: Comparative policy and economic analysis. Patient(s): Couples undergoing ART treatment in the United States, Canada, United Kingdom, Scandinavia, Japan, and Australia. Outcome Measure(s): Description of regulatory and financing arrangements, cycle costs, cost-effectiveness ratios, total expenditure, utilization, and price elasticity. Result(s): Regulation and financing of ART share few general characteristics in developed countries. The cost of treatment reflects the costliness of the underlying healthcare system rather than the regulatory or funding environment. The cost (in 2006 United States dollars) of a standard IVF cycle ranged from $12,513 in the United States to $3,956 in Japan. The cost per live birth was highest in the United States and United Kingdom ($41,132 and $40,364, respectively) and lowest in Scandinavia and Japan ($24,485 and $24,329, respectively). The cost of an IVF cycle after government subsidization ranged from 50% of annual disposable income in the United States to 6% in Australia. The cost of ART treatment did not exceed 0.25% of total healthcare expenditure in any country. Australia and Scandinavia were the only country/region to reach levels of utilization approximating demand, with North America meeting only 24% of estimated demand. Demand displayed variable price elasticity. Conclusion(s): Assisted reproductive technology is expensive from a patient perspective but not from a societal perspective. Only countries with funding arrangements that minimize out-of-pocket expenses met expected demand. Funding mechanisms should maximize efficiency and equity of access while minimizing the potential harm from multiple births. © 2009 American Society for Reproductive Medicine.	en_US
dc.relation.ispartof	Fertility and Sterility	en_US
dc.relation.isbasedon	10.1016/j.fertnstert.2009.04.029	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Infertility, Female	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Reproductive Techniques, Assisted	en_US
dc.subject.mesh	Fertilization in Vitro	en_US
dc.subject.mesh	Decision Trees	en_US
dc.subject.mesh	Developing Countries	en_US
dc.subject.mesh	Patients	en_US
dc.subject.mesh	Population	en_US
dc.subject.mesh	Costs and Cost Analysis	en_US
dc.subject.mesh	Cost-Benefit Analysis	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Japan	en_US
dc.subject.mesh	Female	en_US
dc.title	The economic impact of assisted reproductive technology: a review of selected developed countries	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	91	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	91	en_US

Abstract:

Objective: To compare regulatory and economic aspects of assisted reproductive technologies (ART) in developed countries. Design: Comparative policy and economic analysis. Patient(s): Couples undergoing ART treatment in the United States, Canada, United Kingdom, Scandinavia, Japan, and Australia. Outcome Measure(s): Description of regulatory and financing arrangements, cycle costs, cost-effectiveness ratios, total expenditure, utilization, and price elasticity. Result(s): Regulation and financing of ART share few general characteristics in developed countries. The cost of treatment reflects the costliness of the underlying healthcare system rather than the regulatory or funding environment. The cost (in 2006 United States dollars) of a standard IVF cycle ranged from $12,513 in the United States to $3,956 in Japan. The cost per live birth was highest in the United States and United Kingdom ($41,132 and $40,364, respectively) and lowest in Scandinavia and Japan ($24,485 and $24,329, respectively). The cost of an IVF cycle after government subsidization ranged from 50% of annual disposable income in the United States to 6% in Australia. The cost of ART treatment did not exceed 0.25% of total healthcare expenditure in any country. Australia and Scandinavia were the only country/region to reach levels of utilization approximating demand, with North America meeting only 24% of estimated demand. Demand displayed variable price elasticity. Conclusion(s): Assisted reproductive technology is expensive from a patient perspective but not from a societal perspective. Only countries with funding arrangements that minimize out-of-pocket expenses met expected demand. Funding mechanisms should maximize efficiency and equity of access while minimizing the potential harm from multiple births. © 2009 American Society for Reproductive Medicine.

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http://hdl.handle.net/10453/29768