Estimating the long-term effects of in vitro fertilization in Greece: an analysis based on a lifetime-investment model

Abstract

ObjectiveTo quantify the economic effects of a child conceived by in vitro fertilization (IVF) in terms of net tax revenue from the state’s perspective in Greece.MethodsBased on previous international experience, a mathematical model was developed to assess the lifetime productivity of a single individual and his/her lifetime transactions with governmental agencies. The model distinguished among three periods in the economic life cycle of an individual: (1) early life, when the government primarily contributes resources through child tax credits, health care, and educational expenses; (2) employment, when individuals begin returning resources through taxes; and (3) retirement, when the government expends additional resources on pensions and health care. The cost of a live birth with IVF was based on the modification of a previously published model developed by the authors. All outcomes were discounted at a 3% discount rate. The data inputs – namely, the economic or demographic variables – were derived from the National Statistical Secretariat of Greece and other relevant sources. To deal with uncertainty, bias-corrected uncertainty intervals (UIs) were calculated based on 5000 Monte Carlo simulations. In addition, to examine the robustness of our results, other one-way sensitivity analyses were also employed.ResultsThe cost of IVF per birth was estimated at €17,015 (95% UI: €13,932–€20,200). The average projected income generated by an individual throughout his/her productive life was €258,070 (95% UI: €185,376–€339,831). In addition, his/her life tax contribution was estimated at €133,947 (95% UI: €100,126–€177,375), while the discounted governmental expenses for elderly and underage individuals were €67,624 (95% UI: €55,211–€83,930). Hence, the net present value of IVF was €60,435 (95% UI: €33,651–€94,330), representing a 182% net return on investment. Results remained constant under various assumptions for the main model parameters.ConclusionState-funded IVF may represent good value for money in the Greek setting, since it has positive tax benefits for the government, notwithstanding its beneficial psychological effect on infertile couples.

Long-term fiscal implications of funding assisted reproduction: a generational accounting model for Spain

“…The model’s time horizon is the individual’s life expectancy at birth in Spain in the base year (78 years), which is consistent with previously published empirical models ( Connolly et al, 2008 , Connolly et al, 2009 , Connolly et al, 2011 , Fragoulakis and Maniadakis, 2013 , Kröger and Ejzenberg, 2012 , Svensson et al, 2008 ). Table 2 lists the values assigned to the main parameters used in the base case scenario.…”

“…It is also the first study to compare IVF with AI techniques. Previous studies that have calculated the NFC for the life cycle of an IVF-conceived individual have shown that this can vary, but that, with the exception of The Netherlands ( Moolenaar et al, 2014 ), it remains positive even in economic crisis scenarios: USD 61,428 in Brazil ( Kröger and Ejzenberg, 2012 ); GBP 109,939 in the UK ( Connolly et al, 2009 ); USD 155,870 in the USA ( Connolly et al, 2008 ); SEK 254,000 in Sweden ( Svensson et al, 2008 ); €154,100 in Denmark ( Connolly et al, 2011 ); and €60,435 in Greece ( Fragoulakis and Maniadakis, 2013 ). Our study indicates that public funding of assisted reproductive techniques is likely to result in a positive fiscal return for the Spanish Treasury.…”

“…The long-term fiscal implications of public funding of assisted reproductive treatment have been estimated previously in countries as diverse as Brazil ( Kröger and Ejzenberg, 2012 ), Denmark ( Connolly et al, 2011 ), Sweden ( Svensson et al, 2008 ), the UK ( Connolly et al, 2009 ), the USA ( Connolly et al, 2008 ) and, more recently, Greece ( Fragoulakis and Maniadakis, 2013 ), The Netherlands ( Moolenaar et al, 2014 ), Ukraine, Belarus and Kazakhstan ( Mandrik et al, 2015 ). These studies use generational accounting models that estimate the social net benefit of an IVF-conceived individual.…”

Pharmacoeconomic analysis of long-term effects of more widespread use of in vitro fertilization in infertility treatment at the regional and federal level from the standpoint of society at large in the Russian Federation

“…The results obtained in researches indicated that future monetary flows which would be produced by every human, particularly, tax revenues modified to current date (taking into account time value of money) will significantly exceed current and future expenses on procedures for birth and social support for a child till he (she) would achieve productive age. However, the result of estimation of net present value depends to a high degree on the level of labor productivity in a country, level of incomes, tax policy, and the state policy in the area of health care [9,10,11]. Carrying out of the above researches related to evaluation of long-term economic effects of more widespread use of in vitro fertilization allowed people making decisions in the health care area to obtain assessment of extent of economic burden bearing by the state in case of "unbirth" of every new child in a family suffering from infertility.…”

Information-analytical assessment systems for perinatal outcomes and children’s health status born by assisted reproductive technologies

“…Вице-премьер Ольга Голодец среди основных направлений стимулирования прироста населения, наряду с борьбой с абортами, мерами по снижению смертности, отметила применение вспомогательных репродуктивных технологий (ВРТ) [2]. Опыт многих стран показывает, что ВРТ как меры государственной политики по повышению рождаемости могут создать положительный доминирующий репродуктивный эффект [3,4]. С 1978 г. в мире более 7 млн младенцев рождены благодаря применению ВРТ, однако до сих пор во многих странах, в том числе в Российской Федерации, отсутствуют национальные регистры детей, что не позволяет в должной мере оценить их состояние здоровья.…”