Showing government and business leaders the cost-effectiveness of having infertility coverage is one of the best ways to get new state mandates and employer coverage, says Collura.
And that evidence is mounting. For example, a recent study at Yale University found that the percentage of multiple births resulting from IVF is lower in the eight states that mandate insurance coverage for couples seeking IVF treatment, primarily due to fewer embryos transferred per cycle. Multiple births mean higher rates of medical complications . . . and higher costs for couples and insurance companies. “These results should encourage insurances to provide IVF coverage because it may lower the rate of multiple births, promotes maternal fetal health, and is cost-effective in the long run,” said Pasquale Patrizio, M.D., director of
the Yale Fertility Center.
Some places are getting the message. In Ontario, Canada, a government advisory group concluded that not covering IVF was costing the government money. The panel reported last summer that the government of Ontario could save more than $400 million over the next decade by having the national health insurance program fund IVF procedures, plus an additional $300 million to $460 million over a longer period.
As with the Yale study, the reason has to do with the different ways IVF is done when a couple is paying out of pocket versus when an insurer or government plan is covering all or part of the cost. While most medical experts now advise that whenever possible only one embryo be transferred per IVF cycle, couples who are assuming the costs themselves often opt to have several embryos transferred in order to give themselves the best chance of success (and avoid having to pay for another cycle). That raises the risk of a twin or triplet pregnancy, which is more likely to result in pregnancy complications and premature births. . . meaning increased medical and hospital costs.
Another Canadian province, Quebec, announced in March that it would introduce full Medicare coverage for IVF treatments, making it the first jurisdiction in North America to do so. Beverly Hanck, executive director of the Montreal-based Infertility Awareness Association of Canada, says that her organization’s studies estimate annual savings of between $15 million and $19 million in the cost of preventive hospitalizations, between $8 million and $10 million savings in postnatal costs related to first-year care for low birthweight babies, and $26 million to $33 million savings in long-term savings.
What all this boils down to is that sometimes you have to spend money to save money. And sometimes spending that money is also the right thing to do. The 50 companies in our 2010 list have already realized this wisdom, and we salute their commitment to their employees, and their employees’ families.
A version of this story was originally published in the Summer 2010 issue of Conceive.
