Hum. Reprod. Advance Access published online on December 4, 2008
Human Reproduction, doi:10.1093/humrep/den435
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Assessing long-run economic benefits attributed to an IVF-conceived singleton based on projected lifetime net tax contributions in the UK
1 Health Economics, Global Market Access Solutions, St Prex 1162, Switzerland 2 RAND Europe, Westbrook Centre, Cambridge CB4 1YG, UK 3 Academic Unit of reproductive and Developmental Medicine, University of Sheffield, Sheffield S10 2SF, UK
4 Correspondence address. Tel: +41-789-22-88-96; E-mail: mark{at}gmasoln.com
BACKGROUND: 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.
METHODS: 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.
RESULTS: The lifetime discounted value of net taxes from an IVF-conceived child with mother aged 35 is £109 939 compared with £122 127 for a naturally conceived child. The lifetime undiscounted net tax contribution for the IVF-conceived child and naturally conceived child are £603 000 and £616 000, respectively.
CONCLUSIONS: An investment of £12 931 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.
Key words: health investment/in vitro fertilization (IVF)/generational accounting/economics/live birth
An earlier version of the model and concept described here was previously presented at the ESHRE annual meeting in 2006 as Ledger et al. abstract (i74). M.C. is a former employee of Ferring Pharmaceuticals. Submitted on June 26, 2008; resubmitted on November 4, 2008; accepted on November 5, 2008.