The Costs and Consequences of Assisted Reproductive Technology

An Economic Perspective

Published in: Human Reproduction Update, v. 16, no. 6, Nov.-Dec. 2010, p. 603-613

Posted on RAND.org on December 31, 2009

by Mark P. Connolly, Stijn Hoorens, Georgina M Chanbers

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BACKGROUND: Despite the growing use of assisted reproductive technologies (ART) worldwide, there is only a limited understanding ofthe economics of ART to inform policy about effective, safe and equitable financing of ART treatment. METHODS: A review was undertaken of key studies regarding the costs and consequences of ART treatment, specifically examining thedirect and indirect costs of treatment, economic drivers of utilization and clinical practice and broader economic consequences of ART- conceivedchildren. RESULTS: The direct costs of ART treatment vary substantially between countries, with the USA standing out as the most expensive. Thedirect costs generally reflect the costliness of the underlying healthcare system. If unsubsidized, direct costs represent a significant economicburden to patients. The level of affordability of ART treatment is an important driver of utilization, treatment choices, embryo transfer practicesand ultimately multiple birth rates. The costs associated with caring for multiple-birth ART infants and their mothers are substantial,reflecting the underlying morbidity associated with such pregnancies. Investment analysis of ART treatment and ART-conceived children indicatesthat appropriate funding of ART services appears to represent sound fiscal policy. CONCLUSIONS: The complex interaction between the cost of ART treatment and how treatments are subsidized in different healthcaresettings and for different patient groups has far-reaching consequences for ART utilization, clinical practice and infant outcomes. A greaterunderstanding of the economics of ART is needed to inform policy decisions and to ensure the best possible outcomes from ART treatment

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