Department of Laboratory, Panyu Hexian Memorial Hospital of Guangzhou, Guangzhou, 511400, China.
Department of Health Care, Dongguan Maternal and Child Health Care Hospital, Dongguan, 523112, China.
Sci Rep. 2024 Apr 5;14(1):7998. doi: 10.1038/s41598-024-58640-4.
There are millions of patients experiencing infertility in China, but assisted reproductive technology (ART) is performed at the patient's expense and is difficult to afford. With the sharp decline in China's birth rate, there is a growing controversy over the inclusion of ART in medical insurance (MI). This study aims to explore the feasibility of ART coverage by MI for the first time. We obtained basic data such as the prevalence of infertility, the cost of ART, and the success rate in China with the method of meta-analysis and consulting the government bulletin. Then, we calculated the number of infertile couples in China and the total financial expenditure of MI covering ART. Finally, we discussed the feasibility of coverage, and analyzed the population growth and economic benefits after coverage. According to our research results, it was estimated that there were 4.102-11.792 million infertile couples in China, with an annual increase of 1.189-1.867 million. If MI covered ART, the fund would pay 72.313-207.878 billion yuan, accounting for 2-6% of the current fund balance, and the subsequent annual payment would be 20.961-32.913 billion yuan, accounting for 4-7% of the annual fund balance. This was assuming that all infertile couples would undergo ART, and the actual cost would be lower. The financial input‒output ratio would be 13.022. Benefiting from the inclusion of ART in MI coverage, there would be 3.348-9.624 million new live infants, and 8-13% newborns would be born every year thereafter, which means that by 2050, 37-65 million people would be born. Due to its affordable cost, high cost-effectiveness and favourable population growth, it may be feasible to include ART in MI.
中国有数百万不孕不育患者，但辅助生殖技术（ART）的费用由患者自行承担，难以负担。随着中国出生率的急剧下降，关于将 ART 纳入医疗保险（MI）的争议越来越大。本研究首次旨在探讨 MI 覆盖 ART 的可行性。我们通过荟萃分析和查阅政府公报的方法获得了中国不孕不育的患病率、ART 成本和成功率等基本数据。然后，我们计算了中国不孕夫妇的数量和 MI 覆盖 ART 的总财务支出。最后，我们讨论了覆盖的可行性，并分析了覆盖后的人口增长和经济效益。根据我们的研究结果，估计中国有 410.2-1179.2 万对不孕夫妇，每年增加 118.9-186.7 万对。如果 MI 覆盖 ART，基金将支付 723.133-2078.788 亿元，占当前基金余额的 2-6%，随后每年的支付额将为 209.613-329.133 亿元，占基金余额的 4-7%。这是假设所有不孕夫妇都将接受 ART，实际成本会更低。财务投入-产出比为 13.022。受益于 MI 覆盖范围内的 ART，将有 334.8-962.4 万新生儿，此后每年将有 8-13%的新生儿出生，这意味着到 2050 年，将有 3700-6500 万人出生。由于其价格合理、成本效益高且有利于人口增长，将 ART 纳入 MI 可能是可行的。
