health investment;
in vitro fertilization (IVF);
generational accounting;
economics;
live birth;
POPULATION;
DEMAND;
ART;
D O I:
10.1093/humrep/den435
中图分类号:
R71 [妇产科学];
学科分类号:
100211 ;
摘要:
Over the past decade, demand for fertility treatments has increased as a result of delaying time to first pregnancy and growing awareness and acceptance of available treatment options. Despite increasing demand, health authorities often view infertility as a low health priority and consequently limit access to treatments by rationing and limiting funds. To assess the long-term economic benefits attributed to in vitro fertilization (IVF)-conceived children, we developed a health investment model to evaluate whether state-funded IVF programmes in the UK represent sound fiscal policies. Based on the average investment cost to conceive an IVF singleton, we describe the present value of net taxes derived from gross taxes paid minus direct government transfers received (e.g. education, health, pension) over the lifetime of the child. To establish the present value of investing in IVF, we have discounted all costs from benefits (i.e. lifetime taxes paid) using UK Treasury department rates based on a singleton delivery with similar characteristics for education, earnings, health and life expectancy to a naturally conceived child. The lifetime discounted value of net taxes from an IVF-conceived child with mother aged 35 is 109 pound 939 compared with 122 pound 127 for a naturally conceived child. The lifetime undiscounted net tax contribution for the IVF-conceived child and naturally conceived child are 603 pound 000 and 616 pound 000, respectively. An investment of 12 pound 931 to achieve an IVF singleton is actually worth 8.5-times this amount to the UK Treasury in discounted future tax revenue. The analysis underscores that costs to the health sector are actually investments when a broader government perspective is considered over a longer period of time.
机构:
Ferring Int Ctr, St Prex, SwitzerlandSt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Connolly, Mark P.
Pollard, Michael S.
论文数: 0引用数: 0
h-index: 0
机构:
RAND Corp, Santa Monica, CA USASt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Pollard, Michael S.
Hoorens, Stijn
论文数: 0引用数: 0
h-index: 0
机构:
RAND Corp, Cambridge, EnglandSt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Hoorens, Stijn
Kaplan, Brian R.
论文数: 0引用数: 0
h-index: 0
机构:
Fertil Ctr Illinois, Chicago, IL USASt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Kaplan, Brian R.
Oskowitz, Selwyn P.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Univ, Sch Med, Boston IVF, Boston, MA USA
Harvard Univ, Sch Med, Dept Obstet Gynecol & Reprod Biol, Boston, MA USASt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Oskowitz, Selwyn P.
Silber, Sherman J.
论文数: 0引用数: 0
h-index: 0
机构:
St Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USASt Lukes Hosp, Infertil Ctr St Louis, St Louis, MO 63017 USA
Silber, Sherman J.
[J].
AMERICAN JOURNAL OF MANAGED CARE,
2008,
14
(09):
: 598
-
604