"At a time when politicians discuss how to encourage couples to have more children, due to a falling population in the western world, it is extraordinary that the chronic disease, infertility, should not be paid for by public health systems", she said.
Dr. Granberg and her team looked at all IVF and ICSI cycles in Nordic countries in 2002 and calculated the cost per pregnancy resulting in at least one live-born child. The costs were compared between countries in the Nordic area and over time. They found that the number of treatments had increased substantially over the past eight years, as had the total cost of IVF in the five countries. Depending on policies in the different countries, the total cost to the healthcare system had increased or decreased, but in all countries the proportion of the cost paid by the patients themselves had gone up.
"Including all hospital costs, the 'production' cost of a pregnancy had gone up from €14 000 in 1994 to €20 000 in 2002", said Dr. Granberg, "and when you add the costs of neonatal care, the estimated cost per child was close to €22 000 in 2002. However, the largest part of the healthcare costs of IVF children are those that occur independent of whether the IVF treatment is publicly or privately funded. So decreasing the number of publicly-funded IVF treatments available would not make major savings for healthcare systems." Dr. Granberg's team found that the largest increase in the cost of IVF children was the cost of a normal delivery, which had gone up by 79% between 1994 and 2002. Next came the cost of the drugs needed, which had increased by 76%. The increase in the costs of the IVF itself was relatively small, at 10%. The cost to public healthcare in Nordic countries of IVF had gone up by 137% between 1994 and 2002, but the cost of all public healthcare had also increased substantially, by 79%.
"We found that the number of live births after IVF had increased enormously, from 4093 in 1994 to 7452 in 2002", said Dr. Granberg, "an increase of 82%. Of course, the number of IVF cycles had also gone up - by 65% - but this is an indicator of how much more effective IVF is becoming. Another encouraging factor is to see the reduction in the number of multiple births. For example, in Finland in 2002 only 15% of all IVF births were multiple and in Sweden, after the introduction of legislation regarding single embryo transfer, the multiple birth rate has decreased to under 10% in 2004.
"IVF took up only 0.18% of all public healthcare expenditure in Nordic countries in 2002, an increase of 0.05% over the cost in 1994. However, according to official figures from Sweden, the value of a human life is €2m, and the cost to society per child – healthcare, school etc – is €200 000. If you add to this the IVF 'production cost' of €22 000 per child, and subtract this from the figure for the value of a human life, you will see that IVF is not just valuable for people suffering from infertility, but that it is clearly profitable for society as a whole," she said.