title: Costs and benefits of individuals conceived after IVF: a net tax evaluation in The Netherlands.
abstract: This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative to those naturally conceived. A model based on the method of generational accounting was developed to evaluate investments in IVF. Calculations were based on average investments paid and received from the government by an individual. All costs were discounted to their net present values and adjusted for survival. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive to changes in the growth of healthcare costs, economic growth and the discount rate. Therefore, it is concluded that, similarly to naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits. This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative those naturally conceived. A model based on the method of generational accounting to evaluate investments in IVF was used. Calculations were based on average investments paid and received from the government by an individual. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive for changes in the growth in healthcare costs, economic growth and the discount rate. Just as naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits.
authors.affiliation: Academic Medical Center, Center for Reproductive Medicine, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. Electronic address: L.M.Moolenaar@amc.uva.nl.
authors.forename: L M
authors.initials: LM
authors.lastname: Moolenaar
authors.affiliation: Unit of Pharmaco Epidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, The Netherlands; Health Economics, Global Market Access Solutions, St. Prex 1162, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Connolly
authors.affiliation: Unit of Pharmaco Epidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Huisman
authors.affiliation: Unit of Pharmaco Epidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Postma
authors.affiliation: Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
authors.forename: P G A
authors.initials: PG
authors.lastname: Hompes
authors.affiliation: Academic Medical Center, Center for Reproductive Medicine, Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van der Veen
authors.affiliation: Academic Medical Center, Center for Reproductive Medicine, Amsterdam, The Netherlands.
authors.forename: B W J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000066:Accounting / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018803:Models, Economic; D009426:Netherlands; D013660:Taxes / Q000706:statistics & numerical data*
keywords: economics; generational accounting; health investments; in vitro fertilization (IVF); live birth; net present value