Assisted reproductive technology treatment costs of a live birth: an age-stratified cost-outcome study of treatment in Australia.
OBJECTIVE
To calculate the cost of assisted reproductive technology (ART) treatment cycles and resultant live-birth events.


METHODS
Cost-outcome study based on a decision analysis model of significant clinical and economic outcomes of ART.


METHODS
All non-donor ART treatments initiated in Australia in 2002. Treatment cycles, maternal age and birth outcome data were obtained from the Australian and New Zealand Assisted Reproduction Database. Direct health care costs were obtained from fertility centres, and included government, private insurer and patient costs.


METHODS
Average health care cost of non-donor, fresh and frozen embryo ART treatment cycles. Average and age-specific costs per live-birth event following ART treatment.


RESULTS
Average health care cost per non-donor ART live-birth event was 32,903 US dollars (range, 24,809 US dollars for women < 30 years to 97,884 US dollars for women > or = 40 years). The cost per live birth for women aged > or = 42 years was 182,794 US dollars. The average treatment cost of a fresh cycle was 6,940 US dollars, compared with 1,937 US dollars for a frozen embryo transfer cycle.


CONCLUSIONS
Debate regarding funding for ART services has been hindered by a lack of economic studies of ART treatments and outcomes in Australia. This is the most comprehensive costing study of ART services to date in terms of resources consumed during ART treatment. It confirms that ART treatment is less cost-effective in older women. Alongside economic considerations of ART, community values, ethical judgements and clinical factors should influence policy decision-making.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
Georgina M
GM
Chambers
Maria T
MT
Ho
Elizabeth A
EA
Sullivan
D000328:Adult; D000367:Age Factors; D001315:Australia; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D007231:Infant, Newborn; D007348:Insurance, Health; D050498:Live Birth / Q000191:economics*; D008423:Maternal Age; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000941:ethics