Feasibility analysis of China's medical insurance coverage of assisted reproductive technology

Abstract

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.