title: Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.
abstract: OBJECTIVE
  To examine the costs to the public health care system of couples in medically assisted reproduction.
  
  
  METHODS
  Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment.
  
  
  METHODS
  Specialized public fertility clinics in Denmark.
  
  
  METHODS
  Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic.
  
  
  METHODS
  Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index.
  
  
  METHODS
  Live birth, costs.
  
  
  RESULTS
  Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years.
  
  
  CONCLUSIONS
  The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered.
authors.affiliation: Department of Business and Economics, Center of Health Economic Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Terkel
authors.initials: T
authors.lastname: Christiansen
authors.forename: Karin
authors.initials: K
authors.lastname: Erb
authors.forename: Amra
authors.initials: A
authors.lastname: Rizvanovic
authors.forename: Søren
authors.initials: S
authors.lastname: Ziebe
authors.forename: Anne L
authors.initials: AL
authors.lastname: Mikkelsen Englund
authors.forename: Finn
authors.initials: F
authors.lastname: Hald
authors.forename: Jacky
authors.initials: J
authors.lastname: Boivin
authors.forename: Lone
authors.initials: L
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005298:Fertility / Q000502:physiology*; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D011247:Pregnancy; D011634:Public Health / Q000191:economics; D027724:Reproductive Techniques, Assisted / Q000191:economics*
keywords: Assisted reproductive technology; cohort study; health care costs; infertility; total costs