Objectives: To calculate the cost of assisted reproductive technology (ART) treatment cycles and resultant live-birth events.
Design: Cost-outcome study based on a decision analysis model of significant clinical and economic outcomes of ART.
Setting and participants: All non-donor ART treatments initiated in Australia in 2002. Treatment cycles, maternal age and birth outcome data were obtained from the Australian and New Zealand Assisted Reproduction Database. Direct health care costs were obtained from fertility centres, and included government, private insurer and patient costs.
Main outcome measures: Average health care cost of non-donor, fresh and frozen embryo ART treatment cycles. Average and age-specific costs per live-birth event following ART treatment.
Results: Average health care cost per non-donor ART live-birth event was $32 903 (range, $24 809 for women < 30 years to $97 884 for women ≥ 40 years). The cost per live birth for women aged ≥ 42 years was $182 794. The average treatment cost of a fresh cycle was $6940, compared with $1937 for a frozen embryo transfer cycle.
Conclusions: Debate regarding funding for ART services has been hindered by a lack of economic studies of ART treatments and outcomes in Australia. This is the most comprehensive costing study of ART services to date in terms of resources consumed during ART treatment. It confirms that ART treatment is less cost-effective in older women. Alongside economic considerations of ART, community values, ethical judgements and clinical factors should influence policy decision-making.
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