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1.
Hum Reprod ; 24(3): 626-32, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19056775

ABSTRACT

BACKGROUND: Over the past decade, demand for fertility treatments has increased as a result of delaying time to first pregnancy and growing awareness and acceptance of available treatment options. Despite increasing demand, health authorities often view infertility as a low health priority and consequently limit access to treatments by rationing and limiting funds. METHODS: To assess the long-term economic benefits attributed to in vitro fertilization (IVF)-conceived children, we developed a health investment model to evaluate whether state-funded IVF programmes in the UK represent sound fiscal policies. Based on the average investment cost to conceive an IVF singleton, we describe the present value of net taxes derived from gross taxes paid minus direct government transfers received (e.g. education, health, pension) over the lifetime of the child. To establish the present value of investing in IVF, we have discounted all costs from benefits (i.e. lifetime taxes paid) using UK Treasury department rates based on a singleton delivery with similar characteristics for education, earnings, health and life expectancy to a naturally conceived child. RESULTS: The lifetime discounted value of net taxes from an IVF-conceived child with mother aged 35 is pound 109,939 compared with pound 122,127 for a naturally conceived child. The lifetime undiscounted net tax contribution for the IVF-conceived child and naturally conceived child are pound 603,000 and pound 616,000, respectively. CONCLUSIONS: An investment of pound 12,931 to achieve an IVF singleton is actually worth 8.5-times this amount to the UK Treasury in discounted future tax revenue. The analysis underscores that costs to the health sector are actually investments when a broader government perspective is considered over a longer period of time.


Subject(s)
Fertilization in Vitro/economics , Financing, Government/statistics & numerical data , Health Care Costs/statistics & numerical data , Health Policy/economics , Infertility/therapy , Taxes/statistics & numerical data , Accounting , Federal Government , Female , Fertilization in Vitro/methods , Forecasting , Humans , Models, Economic , Pensions , Pregnancy , Taxes/economics , United Kingdom
3.
Hum Reprod ; 22(9): 2471-5, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17586831

ABSTRACT

Governments worldwide are searching for ways to cope with ageing populations as the demographic shift towards fewer and later births takes hold. The potential contribution of assisted reproductive technologies (ART) to increasing fertility rates has not yet been explored. This paper describes a preliminary study into the impact ART policies might have on population ageing. A deterministic model is developed to quantify the effects of ART policies on total fertility rate (TFR), and tested using data from the UK and Denmark. The population structure for 2050 is modelled to translate fertility rates into time-dependent population dynamics, and the costs of potential ART policies are investigated. If access to ART in the UK were increased to the level of Denmark, the TFR would increase by 0.04, from 1.64 to 1.68. The cumulative effect on the population structure would be a 1.7% decrease in old-age dependency ratio in 2050. Although the empirical models do not include behavioural components, the results demonstrate that ART does have potential to contribute to TFR and influence population structure, and that the direct costs associated with adopting ART as a population policy are comparable with those of existing policies commonly used by governments to influence fertility.


Subject(s)
Aging , Demography , Family Planning Policy , Population , Reproductive Techniques, Assisted/economics , Adult , Age Distribution , Cost-Benefit Analysis , Denmark , Female , Humans , Middle Aged , Models, Theoretical , United Kingdom
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