Expanding access to fertility benefits raises important questions about how those benefits should be designed and what they will cost. A recent study performed by Axene Health Partners (AHP) found that:
- Commonly cited cost figures for in vitro fertilization (IVF) materially understate the true cost of a fertility benefit to a group health plan.
- Pharmacy costs represent roughly half of total IVF cost yet are frequently omitted from published estimates.
- Pregnancies resulting from IVF and intrauterine insemination (IUI) show meaningfully higher prenatal and delivery costs than naturally-conceived pregnancies.
- Babies born through IVF incur substantially higher neonatal and first-year costs.
- IVF outcomes deteriorate with each successive treatment cycle, with the highest-cost cases disproportionately ending in failed conception or no live delivery.
When the cost of the fertility benefit is measured together with the extra costs of maternal prenatal and delivery care, and neonatal care, the estimated total incremental cost of an IVF-conceived birth relative to a naturally-conceived birth is approximately $54,400 – nearly double the procedure cost alone.
These findings are drawn from an actuarial analysis of commercial insurance claims data conducted by Axene Health Partners (AHP) on behalf of the Women’s Reproductive Health Foundation. The analysis used the Merative MarketScan® Commercial Claims database covering five million commercially insured members from 2021 through 2024. Because cash-pay fertility services are excluded from adjudicated claims by definition, all cost figures presented in this paper should be understood as potentially missing additional costs due to cash-pay services not included in the claims data used.
The full white paper includes the complete analysis, with detailed cost breakdowns by treatment type, cycle count and outcome.
Any views or opinions presented in this article are solely those of the author and do not necessarily represent those of the company. AHP accepts no liability for the content of this article, or for the consequences of any actions taken on the basis of the information provided unless that information is subsequently confirmed in writing.
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