OBJECTIVES: Despite the considerable direct and indirect costs of infertility treatment pathways and procedures, there is little evidence on different treatment phases, and the impact of drug acquisition costs used for stimulation to the overall costs. The objective of this study was to source key costing inputs for assisted reproductive technology (ART) leading to a live birth in Spain, Germany, UK, France, Denmark, and Norway.

METHODS: A targeted literature review was performed to determine the costs relevant to ART and grouped to include all treatments and procedures in its different phases. Where needed, clarification was provided by country clinical experts. Estimated total costs for the entire pathway of one ART treatment cycle leading to a live birth were calculated. Costs included the following: ovarian stimulation (monitoring and concomitant medication), oocyte retrieval, fertilization method (ICSI or IVF, according to local clinical practice), fresh embryo transfer, pregnancy follow-up and life birth. Total costs related to one ART treatment cycle leading to a live birth and the proportion attributed to drug acquisition costs were determined.

RESULTS: The total costs of one cycle for ART treatment leading to a live birth varied substantially between countries (€5,525-€9,263), with pregnancy and live birth being the major contributors (ranging from 47-68% of total costs). In contrast, drug acquisition costs contributed only in a limited way to total cost, accounting for 6- 8% (Spain, Norway, France, UK) and up to 14-17% (Denmark, Germany) of the total costs of one ART treatment cycle leading to a live birth.

CONCLUSIONS: The costs associated with pregnancy and live birth were the main contributors, while drug acquisition costs contributed to only 6-17% of total costs related to one ART treatment cycle leading to a live birth.