Academic Medical Center, Center for Reproductive Medicine, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Unit of Pharmaco Epidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, The Netherlands; Health Economics, Global Market Access Solutions, St. Prex 1162, Switzerland.
Reprod Biomed Online. 2014 Feb;28(2):239-45. doi: 10.1016/j.rbmo.2013.10.002. Epub 2013 Oct 10.
This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative to those naturally conceived. A model based on the method of generational accounting was developed to evaluate investments in IVF. Calculations were based on average investments paid and received from the government by an individual. All costs were discounted to their net present values and adjusted for survival. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive to changes in the growth of healthcare costs, economic growth and the discount rate. Therefore, it is concluded that, similarly to naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits. This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative those naturally conceived. A model based on the method of generational accounting to evaluate investments in IVF was used. Calculations were based on average investments paid and received from the government by an individual. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive for changes in the growth in healthcare costs, economic growth and the discount rate. Just as naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits.
本研究评估了通过体外受精(IVF)受孕的个体相对于自然受孕个体的终生未来净税收。建立了一种基于世代核算方法的模型来评估 IVF 的投资。计算基于个人从政府支付和收到的平均投资。所有成本都按其净现值贴现,并根据生存情况进行调整。IVF 受孕个体的终生净现值为-€81374(负号表示净现值为负)。IVF 受孕男性和女性的终生净现值分别为-€47091 和-€123177。自然受孕个体的终生净现值为-€70392;男性和女性的相应金额分别为-€36109 和-€112195。该模型对医疗保健成本增长、经济增长和贴现率的变化最为敏感。因此,结论是,与荷兰自然受孕个体一样,IVF 受孕个体在生命结束时的贴现净税收为负。这里描述的分析框架低估了额外生育的增量价值,因为它只考虑了生命的财政后果,没有考虑更广泛的宏观经济利益。