Candidate for the Lee B. Lusted Student Prize Competition
Purpose: Because of the limited state financing of reproductive programs in Ukraine, Belarus, and Kazakhstan, we assessed the economic benefits of financing in vitro fertilization (IVF) in these countries from the government perspective.
Methods: An economic model was developed to assess the consequences of conceiving a child with IVF. In the model the following governmental expenses were included: drugs needed for IVF procedure, maternal leave, child-support and sick leave payments, medical care, education, unemployment support, and pension. Governmental revenues from population were assessed using direct employment taxes. Other parameters included were first IVF cycle success rate (women younger 40 years) and annual GDP growth rate which defined changes in state revenues and expenses during the life time of a cohort of children born in 2010. By WHO recommendations, 3% discounting was applied to calculate net present value (NPV) and varied from 0% to 10% in one-way sensitivity analyses.
Results: The state income resulting from natural 1000 births during population lifetime was 32 mln., 30 mln., and 8 mln $ for Ukraine, Belarus, and Kazakhstan respectively. Cost for each IVF procedure from a government perspective varied from $1244 in Kazakhstan to $1425 in Belarus. Using the employment taxes calculation, subsidizing 1000 IVF-births resulted in government revenues of 28.7 mln., 26.2 mln. and 4.8 mln $ for Ukraine, Belarus and Kazakhstan respectively. Despite the NPV showing a similar pattern, the value for Kazakhstan – the country with the highest GDP per capita – was lowest among the three countries, because it has significantly lower tax rates combined with relatively high social support. Financing IVF programs had positive a NPV till a discount rate of 6.0 to 8.0% depending on the country.
Conclusion: Subsidizing IVF technologies may provide long-term economic benefits for Ukraine, Belarus, and Kazakhstan. Efficiency of IVF financing may not be directly proportional to the wealth of the country, expressed by GDP, as it is influenced by other parameters, such as tax rates and state expenses on population.
Figure 1. NPV for IVF population in Ukraine,
Belarus, and Kazakhstan