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Publically funded ART-treatment in Sweden

Larsson, Sofie LU and Norrlid, Hanna LU (2013) NEKN01 20132
Department of Economics
Abstract
Background
The trend of postponed reproduction to late in life has increased demand for fertility treatment. The current program of subsidized ART-treatment in Sweden is thoroughly debated and critiqued. The Swedish National Council on Medical Ethics has highlighted the ethical shortcomings of the current system and called for a program change. This thesis expands on the proposal and introduces a medical screening program as a qualification aid for subsidized fertility.
Method and Data
To compare the current Strict Age Limited Program with the Medical Screening Program a cost-effectiveness analysis is conducted. The results are presented as incremental cost-effectiveness ratios (ICER). Data is collected from the RMC clinic and... (More)
Background
The trend of postponed reproduction to late in life has increased demand for fertility treatment. The current program of subsidized ART-treatment in Sweden is thoroughly debated and critiqued. The Swedish National Council on Medical Ethics has highlighted the ethical shortcomings of the current system and called for a program change. This thesis expands on the proposal and introduces a medical screening program as a qualification aid for subsidized fertility.
Method and Data
To compare the current Strict Age Limited Program with the Medical Screening Program a cost-effectiveness analysis is conducted. The results are presented as incremental cost-effectiveness ratios (ICER). Data is collected from the RMC clinic and supplemented with national data (National Quality Register for ART-treatment) in the age groups where RMC data is lacking.
Results
Introducing the Medical Screening Program with the current Strict Age Limited Program generated a cost increase of SEK 2 244 (SEK 20 058) and a rise in the number of live births by 62 (48) for the RMC (Q-IVF) data set. Thereby the analysis resulted in an ICER of SEK 36 (SEK 429). The ICER is thus fairly unaffected while the number of live births rises significantly. A sensitivity analysis shows expected results and the overall effect seems negligible. It is also noteworthy that approxi-mately three fourths of the societal costs of publically funded ART-treatment fall on the health care region, while the rest is divided between the patients and their employers.
Conclusion
Increased availability of publically funded ART-treatment may induce counter-productive behavior but the trend of increased demand is most likely related to shifting social norms. It is essential for western countries to promote fertility rate, due to the economic implications of an aging population, and the Medical Screening Program has potential to do so. (Less)
Please use this url to cite or link to this publication:
author
Larsson, Sofie LU and Norrlid, Hanna LU
supervisor
organization
alternative title
Introducing a medical screening program
course
NEKN01 20132
year
type
H1 - Master's Degree (One Year)
subject
keywords
ART-treatment, fertility, medical screening, health economics, ICSI, IVF, cost-effectiveness analysis
language
English
id
4124194
date added to LUP
2013-10-30 13:17:58
date last changed
2013-10-30 13:17:58
@misc{4124194,
  abstract     = {Background
The trend of postponed reproduction to late in life has increased demand for fertility treatment. The current program of subsidized ART-treatment in Sweden is thoroughly debated and critiqued. The Swedish National Council on Medical Ethics has highlighted the ethical shortcomings of the current system and called for a program change. This thesis expands on the proposal and introduces a medical screening program as a qualification aid for subsidized fertility.
Method and Data
To compare the current Strict Age Limited Program with the Medical Screening Program a cost-effectiveness analysis is conducted. The results are presented as incremental cost-effectiveness ratios (ICER). Data is collected from the RMC clinic and supplemented with national data (National Quality Register for ART-treatment) in the age groups where RMC data is lacking. 
Results 
Introducing the Medical Screening Program with the current Strict Age Limited Program generated a cost increase of SEK 2 244 (SEK 20 058) and a rise in the number of live births by 62 (48) for the RMC (Q-IVF) data set. Thereby the analysis resulted in an ICER of SEK 36 (SEK 429). The ICER is thus fairly unaffected while the number of live births rises significantly. A sensitivity analysis shows expected results and the overall effect seems negligible. It is also noteworthy that approxi-mately three fourths of the societal costs of publically funded ART-treatment fall on the health care region, while the rest is divided between the patients and their employers. 
Conclusion
Increased availability of publically funded ART-treatment may induce counter-productive behavior but the trend of increased demand is most likely related to shifting social norms. It is essential for western countries to promote fertility rate, due to the economic implications of an aging population, and the Medical Screening Program has potential to do so.},
  author       = {Larsson, Sofie and Norrlid, Hanna},
  keyword      = {ART-treatment,fertility,medical screening,health economics,ICSI,IVF,cost-effectiveness analysis},
  language     = {eng},
  note         = {Student Paper},
  title        = {Publically funded ART-treatment in Sweden},
  year         = {2013},
}