title: Assisted reproductive technology: public funding and the voluntary shift to single embryo transfer in Australia.
abstract: OBJECTIVE
  To calculate cost savings to the Australian federal and state governments from the reduction in twin and triplet birth rates for infants conceived by assisted reproductive technology (ART) since 2002, and to determine the number of ART treatment programs theoretically funded by means of these savings.
  
  
  METHODS
  Costing model using data from the Australia and New Zealand Assisted Reproduction Database, the National Perinatal Data Collection and Medicare Australia on ART treatment cycles undertaken in Australia between 2002 and 2008.
  
  
  METHODS
  Annual savings in maternal and infant inpatient birth-admission costs resulting from the reduction in ART multiple birth rate; theoretical number of ART treatment programs funded and infants born by means of these savings.
  
  
  RESULTS
  The reduction in the ART multiple birth rate from 18.8% in 2002 to 8.6% in 2008 resulted in estimated savings to government of $47.6 million in birth-admission costs alone. Theoretically, these savings funded 7042 ART treatment programs comprising one fresh plus one frozen embryo transfer cycle, equating to the birth of 2841 babies. Fifty-five per cent of the increased use of ART services since 2002 has been theoretically funded by the reduction in multiple birth infants.
  
  
  CONCLUSIONS
  Against a backdrop of supportive public funding of ART in Australia, a voluntary shift to single embryo transfer by fertility clinicians and ART patients has resulted in substantial savings in hospital costs. Much of the growth in ART use has been theoretically cross-subsidised by the move to safer embryo transfer practices.
authors: Perinatal and Reproductive Epidemiology Research Unit, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia. g.chambers@unsw.edu.au
authors: Georgina M
authors: GM
authors: Chambers
authors: Peter J
authors: PJ
authors: Illingworth
authors: Elizabeth A
authors: EA
authors: Sullivan
mesh_terms: D001315:Australia; D017046:Cost Savings; D016208:Databases, Factual; D005260:Female; D005380:Financing, Government; D005544:Forecasting; D005102:Health Expenditures; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018803:Models, Economic; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data*; D009520:New Zealand; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000706:statistics & numerical data; D056826:Single Embryo Transfer / Q000191:economics* / Q000639:trends