The willingness to pay for in vitro fertilization: a pilot study using contingent valuation.
The use of in vitro fertilization (IVF) has increased rapidly in recent years and debate has focused on whether health insurance should cover the procedure. We developed and disseminated a contingent valuation survey to investigate how individuals value IVF treatment. Couples pursuing in vitro fertilization can be viewed as purchasing an increased probability of conceiving and bearing a child. In our survey, respondents were asked if they would pay stated amounts for IVF, under various assumptions about the probability of success. The survey explores the ex post perspective, (respondents' willingness to pay (WTP) for IVF in the event that they are infertile), the ex ante perspective, (WTP for IVF insurance, assuming respondents do not know their infertility status), WTP for a public IVF program, and how respondents value IVF relative to mortality risk reduction. Among 150 respondents who were potential childbearers, average WTP was $17,730 for a 10% chance at having a child through IVF in the event of infertility. Average WTP was $865 for a lifetime insurance benefit providing access to a 10% chance. Among 231 respondents of all ages, average WTP was $32 per year in taxes for a public program giving 1,200 couples per year in Massachusetts a 10% chance. The estimated implied ex post WTP per statistical baby was $177,730, while ex ante WTP per statistical baby was $1.8 million. The results of regression analyses were consistent with theoretical predictions, (e.g., increasing WTP with household income). The contingent valuation method is a potentially useful tool in understanding how people value the benefits of IVF. Further research is needed to test the validity of this methodology.
Project HOPE, Center for Health Affairs, Bethesda, MD 20814.
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Johannesson
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D005307:Fertilization in Vitro; D005382:Financing, Personal / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010865:Pilot Projects; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome