Abstract
Assisted reproductive technologies (ARTs) are often considered luxury services by policy-makers and the general population, which are always susceptible of removal from public funding of health care. The analysis of the economic aspects of this scope seems essential due to the high prevalence of infertility in Iran and the high costs of infertility treatments. This study aimed to investigate the value put on IUI and IVF treatments by communities in Iran and the affordability of services based on community preferences. A cost-benefit analysis (CBA) was performed based on the WTP approach, and the contingent valuation method (CVM) was used to estimate WTP for IUI and IVF using a researcher-made survey in two cities of Kerman and Isfahan, Iran, in 2016–17. The sample size was 604, and the study sample frame to estimate WTP included two groups of couples who were/were not aware of their fertility statuses. The costs of one cycle of IUI and IVF were calculated according to the treatment protocols, tariffs of 2016–17, and medical information records of patients. The mean direct and indirect medical costs of one cycle of IUI and IVF were equivalent to 19561140 and 60897610 IRR, respectively. Also, the mean WTP for IUI and IVF treatments were obtained of 15941061 and 28870833 IRR, respectively. The demand for IUI and IVF treatments was elastic and the community was sensitive to price changes of these treatment methods. IUI and IVF treatments brought no positive net benefits, and economic variables had the highest impact on the WTP and community preferences, indicating the significant role of financial constraints in the community's valuation for advanced infertility treatments in Iran.
Highlights
Infertility among couples has become one of the major problems in many countries [1]
Analytic results showed that costs of one cycle of Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) treatments were 19,561,140 and 60897610 IRR with WTP of 15,941,061 and 29535410 IRR, respectively, which indicated that WTP was significantly less than the real costs of one cycle of IUI and IVF and showed lack of positive net benefits as it came from net present value (NPV) and benefit-cost ratio (BCR) results
The results of WTP of IUI and IVF based on each scenario indicated that WTP of couples was sensitive to chances of treatment success
Summary
Infertility among couples has become one of the major problems in many countries [1]. Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) are types of Assisted Reproductive Technologies (ART) used to empower infertile couples to experience a successful pregnancy [6, 7]. IUI is one of the widely applied infertility treatment methods for infertility with unknown factors and with male problems (some sperm disorders). It can be used for the infertility problems caused by the condition of the cervical mucus and sexual disability [8]. The chance of having an embryo in one IVF cycle depends on the patient’s age, the cause of infertility, and the history of infertility treatments (but generally estimated at 20% per cycle) [10]
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