What does it cost to build a family?

By: | Tags: | Comments: 0 | June 2nd, 2017

You’ve done the math. You’ve sat down with your partner and made some difficult decisions. What does it cost to build a family? Do you have to get a second mortgage on your house? Do you have to empty your retirement fund? Why must it cost so much for you and your partner to have a happy, healthy baby, when it often seems so easy for others? You’re not alone in asking these questions. Only a fraction of the couples and individuals in the United States who need fertility treatment actually receive it. In fact, cost of treatment is the most common reason that people don’t pursue the fertility treatment they need to become pregnant.

A recent Forbes article asks, why market principles don’t cause the costs of IVF to decrease, as they do in other market categories. The article argues the case for its title, How IVF Can Be a Laboratory for Free Market Healthcare. Author David Sable, asks the following question:

Is there a formula or strategy, then, to build a large and scalable program that offers outcomes similar to those of the best IVF programs, at a cost that is affordable enough to meet an order of magnitude higher demand and still be profitable?

Mr. Sable’s question charges the prospective IVF center with two tasks:

  1. The cost must be affordable enough to meet higher demand (expand access to care to more patients).
  2. The program must be able to offer outcome similar to those of the best IVF programs (produce equal or better clinical pregnancy success rates).

Some IVF centers offer low cost, or mini IVF, but the clinical pregnancy success rates score far below average. Thus, our second objective, offer similar outcomes to the nation’s best IVF programs, is not achieved.

Other IVF centers participate in IVF Guarantee Programs, in which a commercial entity offers a refund to those couples and individuals who are unable to achieve pregnancy through their IVF program. A recent New York Times article reports that these companies keep careful track of their data and set their prices at profitable points, given the odds. Author Ron Lieber reports that couples may spend as much as $50,000 for these IVF guarantee programs. Thus, our first objective, expand access to care by affordability, is not achieved.

The High Quality Affordable (HQA) fertility care model does not depend on a reduction in services or on financial formulas. Rather, the HQA model achieves above average clinical pregnancy success rates by offering state-of-the-art practices in fertility treatment, which are typically excluded from most IVF packages.  The HQA IVF program, at $8,900, is far less than the national average cost of a single IVF cycle, which Lauren Steussy of the New York Post reports is $12,400. These singular IVF packages seldom include the state-of-the-art methods necessary for best-in-field pregnancy outcomes. These methods include

  • Comprehensive Chromosome Screening (CCS)
  • Intracytoplasmic Sperm Injection (ICSI)
  • Assisted Egg Hatching
  • Next Generation Sequencing (NGS)
  • Freeze-All IVF Cycles

Lastly, Mr. Sable raises the question of size and scale. As of June 2017, the HQA model is open to patients from across the United States and other countries, but is available only in the metropolitan Denver area and Colorado Springs. Our hope is that the HQA model will shift market efficiency from suppliers to consumers and bring down the costs of IVF treatment across the United States.

By Paul Magarelli, MD, PhD

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