The long-term fiscal impact of funding cuts to Danish public fertility clinics

Connolly, Mark P.; Postma, Maarten J.; Crespi, Simone; Andersen, Anders Nyboe; Ziebe, Søren

doi:10.1016/j.rbmo.2011.09.011

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…Based on Danish national register data, Connolly et al. reported an estimated investment of 11 078€ for a mother <40 years to achieve an ART‐conceived singleton. Our detailed cost estimations based on costs for each single treatment step in each observed treatment cycle in a cohort of new couples initiating MAR treatment are thus lower than those based on register data.…”

Section: Discussionmentioning

confidence: 99%

“…In Denmark, MAR treatment contributes substantially to the national birth cohort, with 8–10% of all children being conceived after MAR, which is important in a country with total fertility rates below the replacement level for more than 40 years. Furthermore, over a life‐time, children conceived with MAR will contribute to the net income of the government .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5‐year follow‐up cohort study

Christiansen

Erb

Rizvanovic

et al. 2013

Acta Obstet Gynecol Scand

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5‐year follow‐up cohort study

Christiansen

Erb

Rizvanovic

et al. 2013

Acta Obstet Gynecol Scand

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“…Based on previous international data and experience,16–18 a probabilistic mathematical model was developed to assess the lifetime productivity of a single individual and his/her lifetime transactions with the various governmental agencies. This model was based on cost–benefit analysis principles designed to determine whether a given item of health care expenditure is socially worthwhile.…”

Section: Methodsmentioning

confidence: 99%

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

Fragoulakis¹,

Maniadakis²

2013

CEOR

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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.

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“…Although legal aspects related to medically assisted reproduction are continually being revised in Europe, substantial heterogeneity remains and fosters cross-border reproductive care (CBRC). 23 There are anecdotal reports that the current difficult economic situation in Europe, and beyond, is negatively influencing reimbursement of ART, 24 including deterioration of equal access to fertility treatment, 25 as well as to genetic testing, in general, and to PGD.…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, decreased costs and (at least partial) reimbursement of hormonal stimulation and infertility treatment (if sustained under current economic pressures) may increase the uptake of ART and PGD. 24 , 241 Access to appropriate fertility treatment should become a part of basic human rights 242 for the benefit of current and future generations. 243 …”

Section: Discussion Of Selected Issuesmentioning

confidence: 99%

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

et al. 2013

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In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation – ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide an update of selected topics that have evolved since 2005.

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The long-term fiscal impact of funding cuts to Danish public fertility clinics

Cited by 9 publications

References 15 publications

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5‐year follow‐up cohort study

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5‐year follow‐up cohort study

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

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

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