Office of Health Economics, London, UK
IQVIA, London, UK.
BMJ Open. 2021 Mar 10;11(3):e044986. doi: 10.1136/bmjopen-2020-044986.
To understand attitudes towards infertility and willingness to pay (WTP) towards a publicly funded national assistive reproductive therapies (ART) programme.
Attitudes survey with dichotomous and open-ended WTP questions.
Online survey administered in the USA, UK, Norway, Sweden, Finland, Denmark and China.
7945 respondents, analysed by country. Nordic respondents were pooled into a regionally representative sample.
Primary outcome measures were proportion of sample agreeing with different infertility-related and ART-related value statements and supporting a monthly contribution to fund a national ART programme, expressed in local currency. Secondary outcome measure was maximum WTP.
Across the nationally representative samples, 75.5% of all respondents agreed with infertility as a medical condition and 82.3% and 83.7% with ART eligibility for anyone who has difficulty having a baby or a medical problem preventing them from having a baby, respectively. 56.4% of respondents supported a defined monthly contribution and 73.9% supported at least some additional contribution to fund a national ART programme. Overall, converting to euros, median maximum WTP was €3.00 and mean was €15.47 (95% CI 14.23 to 16.72) per month. Maximum WTP was highest in China and the USA and lowest in the European samples.
This large, multicountry survey extends our understanding of public attitudes towards infertility and fertility treatment beyond Europe. It finds evidence that a majority of the public in all sampled countries/regions views infertility as a treatable medical condition and supports the idea that all infertile individuals should have access to treatments that improve the chance of conception. There was also strong agreement with the idea that the desire for children is a basic human need. WTP questions showed that a majority of respondents supported a monthly contribution to fund a national ART programme, although there is some evidence of an acquiescence bias that may overstate support among specific samples.
了解公众对不孕不育的态度以及对公共资助的全国辅助生殖技术(ART)项目的支付意愿(WTP)。
采用二分法和开放式 WTP 问题的态度调查。
在美国、英国、挪威、瑞典、芬兰、丹麦和中国进行的在线调查。
7945 名受访者,按国家进行分析。北欧受访者被汇总为具有代表性的地区样本。
主要结果测量是样本中同意不同与不孕不育相关和与 ART 相关的价值陈述的比例,并表示支持每月捐款以资助国家 ART 计划,以当地货币表示。次要结果测量是最大 WTP。
在全国代表性样本中,所有受访者中有 75.5%的人同意不孕不育是一种医学疾病,82.3%和 83.7%的人分别同意将任何有生育困难或有医学问题导致无法生育的人纳入 ART 的资格。56.4%的受访者支持每月确定的捐款,73.9%的人支持至少部分额外捐款以资助国家 ART 计划。总体而言,转换为欧元后,中位数最大 WTP 为 3.00 欧元,平均为每月 15.47 欧元(95%CI 14.23 至 16.72)。最大 WTP 在中国和美国最高,在欧洲样本中最低。
这项大型跨国调查扩展了我们对公众对不孕不育和生育治疗的态度的理解,超出了欧洲范围。它表明,所有抽样国家/地区的大多数公众都认为不孕不育是一种可治疗的医学疾病,并支持所有不孕不育者都应获得提高受孕机会的治疗方法的观点。人们也强烈认同生育孩子是人类基本需求的观点。WTP 问题表明,大多数受访者支持每月捐款以资助国家 ART 计划,尽管有一些证据表明,在特定样本中,默许偏见可能夸大了支持率。