The impact of introducing patient co-payments in Germany on the use of IVF and ICSI: a price-elasticity of demand assessment
The impact of introducing patient co-payments in Germany on the use of IVF and ICSI: a price-elasticity of demand assessment
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DOI：
10.1093/humrep/dep260
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发表时间：
2009-11-01
影响因子：
6.1
通讯作者：
Postma, M. J.
中科院分区：
文献类型：
--
作者：
Connolly, M. P.;Griesinger, G.;Postma, M. J.
背景：由于认为不孕症的优先级较低，当局担心医疗费用上升，倾向于针对生殖治疗。2004年，德国卫生当局为患者引入了50%的共同支付，以节省成本。我们探讨了这一定价政策对德国生殖治疗利用的影响。方法：利用德国年度体外受精（IVF）和卵胞浆内单精子注射（ICSI）周期汇总数据，我们通过估计需求的短期价格弹性，评估了引入患者自付从“免费”到（sic）1500-2000后，消费者面临的周期数量变化与成本变化之间的关系。采用交叉价格弹性方法评估了引入患者自付IVF/ICSI对转向其他低成本生育治疗的可能性的影响。结果：在引入患者自付后的一年中，IVF和ICSI周期需求的减少分别导致弹性为-0.41和-0.34。与共付费用相比，IVF/ICSI联合减少的价格弹性估计为-0.36。克罗米芬的交叉价格弹性接近于零（-0.01），表明对这些干预措施的需求是相互独立的，没有替代发生。结论：我们报告在引入1500-2000共同支付后，IVF和ICSI的价格弹性分别为-0.41和-0.34。这些发现可能代表了短期弹性，随着影响生育治疗供求变化的因素的变化，这种弹性可能会随着时间的推移而变化。
BACKGROUND: Authorities concerned by rising healthcare costs have a tendency to target reproductive treatments because of the perception that infertility is a low priority. In 2004 German health authorities introduced a 50% co-payment for patients, in an effort to save cost. We explored the impact of this pricing policy on the utilization of reproductive treatments in Germany.METHODS: Using aggregated annual in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycle data in Germany, we evaluated the relationship between changes in the number of cycles in relation to changes in costs faced by consumers following the introduction of a patient co-payment from 'no fees' to (sic)1500-2000 by estimating the short-run price-elasticity of demand. The impact of introducing patient co-payments for IVF/ICSI on the likelihood of switching to other low-cost fertility treatments was evaluated using the cross-price elasticity methodology.RESULTS: The reduction in demand for IVF and ICSI cycles in the year following the introduction of patient co-payments resulted in elasticities of -0.41 and -0.34, respectively. The price-elasticity for the combined reduction of IVF/ICSI in relation to the co-payment was estimated to be -0.36. The cross-price elasticity for clomifene was close to zero (-0.01) suggesting that demand for these interventions are independent of each other and no substitution occurred.CONCLUSIONS: We report price elasticities for IVF and ICSI of -0.41 and -0.34 after introducing a (sic)1500-2000 co-payment. These findings likely represent short-run elasticities that are likely to vary over time as factors that influence the supply and demand for fertility treatments change.