Health Care Analysis

, Volume 18, Issue 2, pp 113–128 | Cite as

Public Financing of IVF: A Review of Policy Rationales

Original Article


There is great diversity in in vitro fertilization (IVF) funding and reimbursement policies and practice throughout Europe and the rest of the world. While many existing reimbursement and regulatory frameworks address safety and legal concerns, economic factors also assume a central role. However, there are several problems with the evidence that is available on the economics of IVF. This suggests there is a need for more robust cost-effectiveness studies. It also indicates the need for alternative rationales to justify the reimbursement of IVF, which might more fully account for the social, political, ethical, and philosophical considerations embedded in notions of infertility and technology-driven reproductive treatments. The merits and limitations of five alternative rationales are discussed. The review suggests that while no existing single rationale provides a complete framework with which to support funding decisions, taken together they provide guideposts which signal important issues for consideration and highlight where further research, action, and debate are needed.


Assisted reproduction Cost-effectiveness Equity Health care financing Health policy Infertility IVF Medical need 



The authors are grateful to the anonymous referees for their helpful comments and suggestions and to Elias Mossialos and Harald Schmidt for their input into certain sections of the article. Part of this article is based on research undertaken for a project funded by the European Commission, DG Employment, Social Affairs and Equal Opportunities, on health status and living conditions in the EU, Contract No. VC/2005/0781. All the views expressed are the authors’ own.


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© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.London School of Economics, LSE HealthLondonUK

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