title: Economic value of in vitro fertilization in Ukraine, Belarus, and Kazakhstan.
abstract: BACKGROUND
  An economic value calculation was performed to estimate the lifetime net present value of in vitro fertilization (IVF) in Ukraine, Belarus, and Kazakhstan.
  
  
  METHODS
  Net lifetime tax revenues were used to represent governmental benefits accruing from a hypothetical cohort of an IVF population born in 2009 using the methodology of generational accounting. Governmental expenses related to this population included social benefits, education and health care, unemployment support, and pensions. Where available, country-specific data referencing official sources were applied.
  
  
  RESULTS
  The average health care cost needed to achieve one additional birth from the governmental perspective varied from $2,599 in Ukraine to $5,509 in Belarus. The net present value from the population born using IVF was positive in all countries: for Ukraine ($9,839), Belarus ($21,702), and Kazakhstan ($2,295). The break-even costs of drugs and supplies per IVF procedure is expected to be $3,870, $8,530, and $1,780, respectively. Probabilistic sensitivity analyses based on 5,000 simulations show that the average net present value per person remains positive: $1,894±$7,619, $27,925±$12,407, and $17,229±$24,637 in Ukraine, Belarus, and Kazakhstan, respectively.
  
  
  CONCLUSIONS
  Financing IVF may represent a good investment in terms of governmental financial returns, even in lower-income countries with state-financed health care systems such as Ukraine, Belarus, and Kazakhstan.
authors.affiliation: Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands.
authors.forename: Olena
authors.initials: O
authors.lastname: Mandrik
authors.affiliation: Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands ; National Health Care Institute, Diemen, the Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Knies
authors.affiliation: Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands ; iMTA Institute of Medical Technology Assessment, Erasmus University, Rotterdam, the Netherlands.
authors.forename: Johan L
authors.initials: JL
authors.lastname: Severens
keywords: developing countries; economic value of life; in vitro fertilization