Direct health services costs of providing assisted reproduction services in older women
Presented at British Fertility Society Summer College, September 4, 2008, Liverpool, U.K.
Received 14 November 2008; received in revised form 16 January 2009; accepted 19 January 2009. published online 03 March 2009.
Objective
To assess the total health service costs incurred for each live birth achieved by older women undergoing IVF compared with costs in younger women.
Design
Retrospective cross-sectional analysis.
Setting
In vitro fertilization unit and maternity hospital in a tertiary care setting.
Patient(s)
Women who underwent their first cycle of IVF between 1997 and 2006.
Intervention(s)
Bottom-up costs were calculated for all interventions in the IVF cycle. Early pregnancy and antenatal care costs were obtained from National Health Service reference costs, Information Services Division Scotland, and local departmental costs.
Main Outcome Measure(s)
Cost per live birth.
Result(s)
The mean cost per live birth (95% confidence interval [CI]) in women undergoing IVF at the age of ≥40 years was £40,320 (£27,105–£65,036), which is >2.5 times higher than those aged 35–39 years (£17,096 [£15,635–£18,937]). The cost per ongoing pregnancy was almost three times in women aged ≥40 (£31,642 [£21,241–£58,979]) compared with women 35–39 years of age (£11,300 [£10,006-£12,938]).
Conclusion(s)
The cost of a live birth after IVF rises significantly at the age of 40 years owing to lower success rates. Most of the extra cost is due to the low success of IVF treatment, but some of it is due to higher rates of early pregnancy loss.
aDepartment of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, Scotland
bHealth Economics Research Unit, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, Scotland
cDepartment of Public Health, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, Scotland
Reprint requests: Abha Maheshwari, Clinical Lecturer and Subspeciality Trainee in Reproductive Medicine, University Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZL, U.K. (FAX: + 44 1224 551072).
A.M. has nothing to disclose. G.S. has nothing to disclose. J.B. has nothing to disclose. A.M. has nothing to disclose. M.H. has nothing to disclose. S.B. has nothing to disclose.
Supported by National Health Service Endownment (07/63) and the University of Aberdeen.
ABSTRACT