Abstract
BackgroundHealth state utility values allow for comparison of treatments across different diseases. Utility values for fertility-impaired health states are currently unavailable. Such values are necessary in order to determine the relative costs-effectiveness of fertility treatments.MethodsThis study aimed to determine utility weights for infertile and subfertile health states. In addition, it explored the Dutch general population’s opinions regarding the inclusion of infertility treatments in the Dutch health insurers’ basic benefit package. An online questionnaire was designed to determine the health-related quality of life values of six fertility-impaired health states. The study population consisted of a representative sample of the Dutch adult population. Respondents were asked to evaluate the health states through direct health valuation methods, i.e. the Visual Analogue Scale (VAS) and the Time Trade-Off (TTO) method. In addition, respondents were asked about their opinions regarding reimbursement of fertility-related treatments.ResultsThe respondents’ (n = 767) VAS scores ranged from 0.640 to 0.796. TTO utility values ranged from 0.792 to 0.868. Primary infertility and subfertility was valued lower than secondary infertility and subfertility. In total, 92% of the respondents stated that fertility treatments should be fully or partially reimbursed by the health insurance basic benefit package.ConclusionsHaving fertility problems results in substantial disutilities according to the viewpoint of the Dutch general population. The results make it possible to compare the value for money of infertility treatment to that of treatments in other disease areas. There is strong support among the general population for reimbursing fertility treatments through the Dutch basic benefit package.
Highlights
Health state utility values allow for comparison of treatments across different diseases
In the Netherlands, these treatments are often paid for by the health insurers. It is regularly questioned whether such treatments should be paid from national health care budgets, since people may not directly consider infertility to be a condition for which society should pay the treatment
There self-reported health on the Visual Analogue Scale (VAS) was lower than reported in another general population time trade-off survey [20]
Summary
Health state utility values allow for comparison of treatments across different diseases. Utility values for fertility-impaired health states are currently unavailable. Such values are necessary in order to determine the relative costs-effectiveness of fertility treatments. 15% of reproductive-aged couples experience infertility worldwide [19]. Infertility is defined as permanently being unable to have children and subfertility as having trouble conceiving and not knowing whether potential fertility treatments will be successful. Mascarenhas et al estimated that 48.5 million couples worldwide are unable to fulfill their desire for a child (which was defined as not being able to conceive in the past five years). About half of the couples in industrialized countries facing infertility seek medical help [18]. Fertility problems affect individuals in high income countries, as well as individuals in middle- and low-income countries [15]
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