Mandrik Olena, Knies Saskia, Severens Johan L
Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands.
Institute of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands ; National Health Care Institute, Diemen, the Netherlands.
Clinicoecon Outcomes Res. 2015 Jun 12;7:347-56. doi: 10.2147/CEOR.S79513. eCollection 2015.
An economic value calculation was performed to estimate the lifetime net present value of in vitro fertilization (IVF) in Ukraine, Belarus, and Kazakhstan.
Net lifetime tax revenues were used to represent governmental benefits accruing from a hypothetical cohort of an IVF population born in 2009 using the methodology of generational accounting. Governmental expenses related to this population included social benefits, education and health care, unemployment support, and pensions. Where available, country-specific data referencing official sources were applied.
The average health care cost needed to achieve one additional birth from the governmental perspective varied from $2,599 in Ukraine to $5,509 in Belarus. The net present value from the population born using IVF was positive in all countries: for Ukraine ($9,839), Belarus ($21,702), and Kazakhstan ($2,295). The break-even costs of drugs and supplies per IVF procedure is expected to be $3,870, $8,530, and $1,780, respectively. Probabilistic sensitivity analyses based on 5,000 simulations show that the average net present value per person remains positive: $1,894±$7,619, $27,925±$12,407, and $17,229±$24,637 in Ukraine, Belarus, and Kazakhstan, respectively.
Financing IVF may represent a good investment in terms of governmental financial returns, even in lower-income countries with state-financed health care systems such as Ukraine, Belarus, and Kazakhstan.
进行了一项经济价值计算,以估算乌克兰、白俄罗斯和哈萨克斯坦体外受精(IVF)的终身净现值。
使用代际核算方法,将终身净税收收入用于代表2009年出生的假设IVF人群队列所产生的政府收益。与该人群相关的政府支出包括社会福利、教育和医疗保健、失业支持及养老金。在可行的情况下,采用了引用官方来源的特定国家数据。
从政府角度来看,实现一次额外生育所需的平均医疗保健成本在乌克兰为2599美元,在白俄罗斯为5509美元。所有国家中,使用IVF出生人群的净现值均为正值:乌克兰为9839美元,白俄罗斯为21702美元,哈萨克斯坦为2295美元。预计每个IVF程序的药品和耗材收支平衡成本分别为3870美元、8530美元和1780美元。基于5000次模拟的概率敏感性分析表明,人均平均净现值仍为正值:乌克兰为1894±7619美元,白俄罗斯为27925±12407美元,哈萨克斯坦为17229±24637美元。
就政府财政回报而言,资助IVF可能是一项不错的投资,即使在乌克兰、白俄罗斯和哈萨克斯坦等有国家资助医疗保健系统的低收入国家也是如此。