ASSISTED REPRODUCTIVE TECHNOLOGIES (ARTS) IN ALBERTA, CANADA: AN ECONOMIC ANALYSIS TO INFORM POLICY DECISION-MAKING

Purpose:

Regulation and funding of assisted reproductive technologies (ARTs) vary across the Canadian provinces. In Alberta, there is neither regulation nor public funding of ARTs. This study evaluated the cost effectiveness and budget impact of providing ARTs in Alberta under 3 different policy scenarios (a ‘restrictive’ policy, a policy based on Quebec’s model, and a ‘permissive’ policy) in comparison to the status quo.

Method:

To predict the budget impact and cost-effectiveness of three policy options for publicly funded ARTs in Alberta, an economic model was developed by combining a state transition Markov model and a decision tree. The primary outcome of was the ‘cost per healthy singleton’.  Probabilistic and one way sensitivity analyses were conducted.

Result:

The ‘restrictive’ policy option was the most cost effective option for two subgroups of age <35 years and 35 to 39 years while the Quebec policy option was most cost effective for the ≥40 years subgroup. Budget impact analysis revealed highest cost savings of $49.12 million and 12.29 million for the restrictive policy for the <35 years subgroup and 35-39 years subgroup, respectively. For the >40 years subgroup, the Quebec policy option was cost saving, with total savings of $11.02 million. Sensitivity analyses showed that the model results were robust.

Conclusion:

There is a need for comprehensive ‘healthy’ public policy that balances access to IVF for childless infertile couples with effective and efficient use of healthcare system resources.  This may be achieved through funding mechanisms that encourage healthy child birth and minimize the likelihood of multiple births. This economic modelling study shows that the publicly funded and scientifically regulated ARTs could provide treatment access and save health care expenditures for the province.