Health state utilities for infertility and subfertility

Abstract

Background Health state utility values allow for comparison of treatments across different diseases. Utility values for fertility-impaired health states are currently unavailable. Such values are necessary in order to determine the relative costs-effectiveness of fertility treatments. Methods This study aimed to determine utility weights for infertile and subfertile health states. In addition, it explored the Dutch general population’s opinions regarding the inclusion of infertility treatments in the Dutch health insurers’ basic benefit package. An online questionnaire was designed to determine the health-related quality of life values of six fertility-impaired health states. The study population consisted of a representative sample of the Dutch adult population. Respondents were asked to evaluate the health states through direct health valuation methods, i.e. the Visual Analogue Scale (VAS) and the Time Trade-Off (TTO) method. In addition, respondents were asked about their opinions regarding reimbursement of fertility-related treatments. Results The respondents’ ( n = 767) VAS scores ranged from 0.640 to 0.796. TTO utility values ranged from 0.792 to 0.868. Primary infertility and subfertility was valued lower than secondary infertility and subfertility. In total, 92% of the respondents stated that fertility treatments should be fully or partially reimbursed by the health insurance basic benefit package. Conclusions Having fertility problems results in substantial disutilities according to the viewpoint of the Dutch general population. The results make it possible to compare the value for money of infertility treatment to that of treatments in other disease areas. There is strong support among the general population for reimbursing fertility treatments through the Dutch basic benefit package.

Magnitude of infertility and associated factors among women attending selected public hospitals in Addis Ababa, Ethiopia: a cross-sectional study

“…Pregnancy may take longer when a couple is subfertile. However, they can become pregnant on their own without medical help, as opposed to a condition called infertility [ 3 , 4 ]. The source of infertility can be woman, man, both, or unexplained [ 5 , 6 ].…”

Success rate and ART outcome of microsurgical sperm extraction in non obstructive azoospermia: A retrospective study

“…Infertility is a reproductive health problem (1) which affects approximately 15-20% of couples (2,3). Prevalence of primary lifetime infertility in Iran is about 25% (4).…”

Unmet Parenthood Goals, Health-Related Quality of Life and Apparent Irrationality: Understanding the Value of Treatments for Infertility

“…As we noted earlier, NICE recognises infertility as a medical condition [19]. However, as implied by Krol et al [20], the 'symptoms' of this condition are unlikely to manifest on dimensions that NICE considers health related. For individuals with stronger parenthood goals, failing to achieve these goals could conceivably lead to depression or anxiety that would be reflected in HRQOL, but this is likely to be a minority of all individuals with unmet parenthood goals [27].…”

“…The implication of this view is usefully illustrated by Krol et al [20]. The authors conducted a time trade-off (TTO) study to understand the utility of involuntary childlessness relative to full health in a general population sample.…”