title: Assisted Reproductive Technologies in Alberta: An Economic Analysis to Inform Policy Decision-Making.
abstract: OBJECTIVE
  Regulation and public funding of assisted reproductive technologies (ARTs) vary across the Canadian provinces. In Alberta, neither of these exists. We conducted this study to evaluate the cost effectiveness and budget impact of providing ARTs in Alberta under three different policy scenarios (a "restrictive" policy, a policy based on Quebec's model, and a "permissive" policy) in comparison with the status quo.
  
  
  METHODS
  To predict the cost effectiveness and budget impact of three policy options for publicly funded ARTs in Alberta, we developed an economic model by combining a state transition Markov model and a decision tree. The primary outcome was cost per healthy singleton. Probabilistic and one-way sensitivity analyses were conducted.
  
  
  RESULTS
  The restrictive policy was the most cost effective option for two subgroups of age (< 35 years and 35 to 39 years), while the Quebec policy option was most cost-effective for the ≥ 40 years subgroup. Budget impact analysis extending up to the age of 18 years for the children in the model showed the cost savings of $8.33 million for the restrictive policy for the < 35 years subgroup. For the ≥ 40 years subgroup, the Quebec policy option resulted in total cost savings of $3.75 million. Sensitivity analyses showed that the model results were robust.
  
  
  CONCLUSIONS
  This economic modelling study shows that publicly funded and scientifically regulated ARTs could provide treatment access and save health care expenditures for the province.
authors.affiliation: Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton AB.
authors.forename: Anil
authors.initials: A
authors.lastname: Vaidya
authors.affiliation: Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton AB.
authors.forename: Tania
authors.initials: T
authors.lastname: Stafinski
authors.affiliation: Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton AB.
authors.forename: Alexa
authors.initials: A
authors.lastname: Nardelli
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Alberta, Edmonton AB.
authors.forename: Tarek
authors.initials: T
authors.lastname: Motan
authors.affiliation: Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton AB.
authors.forename: Devidas
authors.initials: D
authors.lastname: Menon
mesh_terms: D000328:Adult; D000416:Alberta; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D011050:Policy Making; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data
keywords: assisted reproductive technologies; budget impact analysis; cost-effectiveness analysis; decision modelling