Valuing live births from assisted reproduction: A health economics viewpoint |
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| Affiliation: | 1. Global Market Access Solutions, Health Economics Unit, St-Prex, Switzerland;2. University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;3. Unit of Pharmacoepidemiology & Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands;1. Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Via Giardini 1355, 41126 Modena, Italy;2. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125, Modena, Italy;1. Department of Global and Community Health, George Mason University, 4400 University Dr., MS 5B7, Fairfax, VA 22030, USA;2. Department of Obstetrics and Gynecology, Medical University of South Carolina, Rm 634, Clinical Science Bldg., 96 Jonathan Lucas St., Charleston, SC 29425, USA;1. Department of Obstetrics & Gynecology, Queen''s University, Kingston Health Sciences Centre, Kingston, ON, USA;2. Department of Obstetrics & Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, ON, USA;3. Department of Obstetrics & Gynecology, University of Calgary, Calgary, Alberta, USA |
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| Abstract: | Infertility is a medical condition that can be overcome, thanks to advances in medically assisted reproductive (MAR) therapies. Despite the ultimate measure of MAR efficacy being the birth of a new human being, there are ethical and methodological questions as to which outcome best translates the value of MAR in cost-effectiveness analyses. Many authors favour cost per life birth outcomes instead of more traditional cost per quality-adjusted life years (QALYs), which raises generalizability issues for decision-makers. Nonetheless, infertility and infertility treatments substantially differ from other health conditions and health treatments, particularly in the way they affect the quality of life of the infertile couple. Collecting quality of life measures in infertility and pregnancy is also surrounded by challenges not easily overcome. We reflect on cost-effectiveness methods applied to MAR technologies, on ethical considerations for valuing a MAR-generated life, and on its broader societal value for consideration by decision-makers. |
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| Keywords: | Infertility Medically assisted reproduction Economic value of life Health economics Human capital Quality-adjusted life year (QALY) |
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