Analysis of out-of Pocket Payment Associated to Female Infertility in Hungary between 2015-2022

OBJECTIVES: In Hungary, the number of live births has been decreasing for more than two decades. The government has set a national strategic purpose to increase the accessibility to infertility treatments. The reform started in 2019, resulting in a significant increase in the state's involvement in providing and financing infertility treatments. This paper evaluates private out-of-pocket (OOP) expenditure related to infertility about pharmaceutical utilization in Hungary.

METHODS: The turnover data of prescriptions for infertility diagnoses was analyzed. The following WHO ICD (revision X.) infertility diagnoses were included in the study: N97; N97.1; N97.2; N97.3; N97.4; N97.8; N97.9. The study analyzed annual OOP associated with different infertility diagnoses. Moreover, the market share linked to pharmaceutical products was also evaluated. The study database was provided by the Health Data Warehouse of the National Hospital General Directorate.

RESULTS: The total OOP expenditure for infertility-related pharmaceutical utilization was 18.37 million USD in Hungary. The highest level was identified in 2017 (3.50 million USD) while the lowest was in 2022 (0.83 million USD). A significant difference was captured in expenditure linked to diagnosis. The highest market share was represented by N97.9 ICD (female infertility, unspecified; 15.33 million USD). Expenditure by active substance had a varied picture as well. The highest expenditure was associated with follitropin alfa (8.06 million USD), human menopausal gonadotropin (3.57 million USD), and progesterone (3.31 million USD).

CONCLUSIONS: The OOP expenditure has decreased in the study period, especially from 2020. From that year onwards, the government took on a greater role by increasing public subsidies for infertility-related drugs. Based on the result, the financial burden of Hungarian patients related to infertility drugs has been relieved.