Keller E, Botha W, Ortmann A, Jorm LR, Chambers GM. Does fertility treatment provide good value for money? A cost-benefit analysis. Poster presented at the Virtual ISPOR Asia Pacific 2020; September 2020. [abstract] Value in Health Regional Issues. 2020 Sep; 22(Supplement):S44.

OBJECTIVES: To undertake a cost-benefit analysis (CBA) to assess value for money of fertility treatments from a taxpayer perspective in Australia as well as to determine the number of cost-beneficial treatment cycles for women of different ages.

METHODS: To determine the net monetary benefit (NMB) of fertility treatment, we developed a Markov model from a societal perspective with health states representing non-assisted reproductive technologies (ART) as well as ART treatments and a one-year time horizon given that benefit measures are calculated based on annual tax contributions. The model was analysed using Monte Carlo simulation with parallel trials to incorporate total willingness to pay (WTP) in tax contributions available for funding of fertility treatment. The model was populated using data from the Australian and New Zealand Assisted Reproduction Database (ANZARD), a recent stated preference discrete choice experiment (DCE) of taxpayers’ WTP for fertility treatment and fees charged by Australian fertility clinics. Incremental cost-benefit ratios and net-benefit acceptability curves were generated.

RESULTS: Given that success rates decrease with increasing age, our CBA clearly shows that, generally, the younger a woman is, the more treatment cycles are cost-beneficial. Preliminary results indicate that ≤8 complete treatment cycles provide good value for money for women aged ≤35 years. However, with increasing age this number decreases and at ages ≥42 years provision of fertility treatment was found to not provide good value for money.

CONCLUSIONS: This is the first study to adopt a CBA framework for fertility treatment. The provision of fertility treatment is valued highly by society. However, from a taxpayer perspective, due to higher success rates, such therapies provide better value in younger women. The results can inform discussions about treatment funding.

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