The economic burden of infertility treatment and distribution of expenditures overtime in France: a self-controlled pre-post study

Abstract

Background Recent cost studies related to infertility treatment have focused on assisted reproductive technologies. None has examined lower-intensity infertility treatments or analyzed the distribution of infertility treatment expenditures over time. The Purpose of the study was to analyse the size and distribution of infertility treatment expenditures over time, and estimate the economic burden of infertility treatment per 10,000 women aged 18 − 50 in France from a societal perspective. Methods We used French National individual medico-administrative database to conduct a self-controlled before-after analytic cohort analysis with 556 incidental women treated for infertility in 2014 matched with 9,903 controls using the exact matching method. Infertility-associated expenditures per woman and per 10,000 women over the 3.5-year follow-up period derived as a difference-in-differences. Results The average infertility related expenditure per woman is estimated at 6,996 (95% CI: 5,755–8,237) euros, the economic burden for 10,000 women at 70.0 million (IC95%: 57.6–82.4) euros. The infertility related expenditures increased from 235 (IC95%: 98–373) euros in semester 0, i.e. before treatment, to 1,509 (IC95%: 1,277–1,741) euros in semester 1, mainly due to ovulation stimulation treatment (47% of expenditure), to reach a plateau in semesters 2 (1,416 (IC95%: 1,161–1,670)) and 3 (1,319 (IC95%: 943–1,694)), where the share of expenses is mainly related to hospitalizations for assisted reproductive technologies (44% of expenditure), and then decrease until semester 6 (577 (IC95%: 316–839) euros). Conclusion This study informs public policy about the economic burden of infertility estimated at 70.0 million (IC95%: 57.6–82.4) euros for 10,000 women aged between 18 and 50. It also highlights the importance of the share of drugs in infertility treatment expenditures. If nothing is done, the increasing use of infertility treatment will lead to increased expenditure. Prevention campaigns against the preventable causes of infertility should be promoted to limit the use of infertility treatments and related costs.

Women infertility and common mental disorders: A cross-sectional study from North India

“…As observed by the field investigators of the present study, exercise among infertile women is one of the recommendations of the doctors as a part of their treatment protocol specifically for the reduction of PCOS and other related infertility issues. Some intervention and prospective studies have also demonstrated that lesser exercise results in higher levels of perceived stress [ 25 , 26 ]. Further, clinical trials have demonstrated that exercise is an effective method for reducing perceived stress, stress symptoms, and quality of life [ 25 ].…”

“…Some intervention and prospective studies have also demonstrated that lesser exercise results in higher levels of perceived stress [ 25 , 26 ]. Further, clinical trials have demonstrated that exercise is an effective method for reducing perceived stress, stress symptoms, and quality of life [ 25 ]. Among the fertile group, physically active women were found to be more stressed, which could be due to workload, the pressure of household chores, or other family or children-related issues [ 27 ].…”

Reproductive and Obstetric Outcomes after Fertility-Sparing Treatments for Cervical Cancer: Current Approach and Future Directions

“…Approximately 80 million people and about one-fifth of couples during their lifetime are affected by infertility worldwide [ 1 , 2 , 3 ]. In addition, infertility has a significant economic impact and is a multilayered stressor associated with anxiety, depression, and dysfunctions in marital and sexual relationships that affect quality of life [ 4 , 5 , 6 ].…”

Trends in clomiphene citrate and gonadotropins use in women with infertility between 2010 and 2017: A population‐based study in France

“…The economic burden is also high, largely due to ART techniques 6 . A study in France recently analysed the size and distribution of expenditure related to infertility treatment over time, and estimated the economic burden of infertility treatment in France 7 . One of the main results, in addition to quantifying the economic burden of infertility management (estimated at 6996 [95% CI: 5755–8237] euros over a 3.5‐year follow‐up period), was demonstrating the significant share of health care expenses related to drugs, especially in the first two semesters of infertility management (47% and 35% of expenses, respectively).…”