Between politics and clinics -- the many faces of biomedical policy in Europe

Analysis of drivers and outcomes of Assisted Reproductive Technologies policy -- Volume I: Synthesis report

by Stijn Hoorens, Annalijn Conklin, Jan Tiessen

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Abstract

Now thirty years on from the first “test-tube baby”, assisted reproduction continues to feature in the media and is high on the political agendas in many countries in Europe. Our study aimed to shed light on the substantial differences in the way governments have shaped their Assisted Reproductive Technologies policy by studying three European countries in depth — France, Italy and the UK. Organised in two volumes, we report our findings and analysis of a comparative study on ART policy in these three countries based on an extensive iterative review of the evidence and collection of country-specific information gathered for the three country case studies. In brief, we found that ART policy has many faces despite a common European regulatory framework for human tissues and cells; although there are differences in economic contexts between countries, all have a proportion of individual payment; and, good clinical practice can be trumped by regulatory restrictions as well as funding arrangements, leading to undesired health outcomes and even cross-border travel. We also identified a number of different underlying factors driving the differences in ART policy between the three countries. In concluding, we offer a number of recommendations towards addressing the key challenges of such context-specific differences.

This report will be of interest to policymakers, clinicians, patients and researchers who are concerned with the regulation, policy implementation, funding and clinical practice of ART and its wider context and outcomes.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Analytical approach

  • Chapter Three

    Assisted Reproductive Technologies in France: liberté, fraternité et générosité

  • Chapter Four

    Italy: from far west to stringent south

  • Chapter Five

    United Kingdom: postcode lottery in a reputable system

  • Chapter Six

    Between politics and clinics: a synthesis of differences and their drivers

  • Chapter Seven

    From policy to parent: linking Assisted Reproductive Technology policy systems to their outcomes

  • Chapter Eight

    Conclusion and recommendations

Research conducted by

The research described in this report was supported by a grant from Schering-Plough and was conducted by RAND Europe.

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