Economic value of in vitro fertilization in Ukraine, Belarus, and Kazakhstan

Figures & data

Table 1 Neonatal costs of IVF population in Ukraine, Belarus, and Kazakhstan (US$)

Parameter	Ukraine	Belarus	Kazakhstan
Drugs costs
Option 1 IVF costs per cycle(47% cycles)	741	1,795	927
Option 2 IVF costs per cycle (43% cycles)	538	1,129	1,243
Option 3 IVF costs per cycle(10% of cycles)	782	1,902	905
Medical supplies IVF costsper cycle	75	88	79
Average drugs and supplies costs, per one cycle	732	1,607	1,049
Health care expenditures per one IVF cycle	48	58	147
Health care pregnancy and delivery expenditures, per one birth	153	287	409
Average costs neededto achieve one IVF birth	2,599	5,509	4,157

Abbreviation: IVF, in vitro fertilization.

Figure 1 Projected net present value for child conceived by IVF in Ukraine, Belarus, and Kazakhstan.

Abbreviations: IVF, in vitro fertilization; NPV, net present value.

Table 2 Cost and income of IVF-conceived population in Ukraine, Belarus, and Kazakhstan

Scenario	Lifetime NPV* ($)
	Ukraine	Belarus	Kazakhstan
Expenses
Social (maternity) support and sick leaves	2,976	5,734	5,700
Education	4,045	6,021	7,050
Health care costs	7,617	35,463	42,024
Unemployment	31	2.17	52,342
Pension	8,881	55,852	45,125
Total state expenseson IVF population	26,150	106,580	104,108
Revenue
Revenue from population Net income	37,687	128,282	106,403
Net present value of IVF	9,839	21,702	2,295
Net present value of IVF incountry-specific scenarios	8,879	21,139	2,040

Note:

* Average per birth.

Abbreviations: IVF, in vitro fertilization; NPV, net present value.

Table 3 One-way sensitivity analysis (mothers’ age, IVF drug costs, and discounting rate)

Scenario	Lifetime NPV (US$)
	Ukraine	Belarus	Kazakhstan
NPV of child conceived by IVF, mother aged <35 years (40.1% success rate)	10,339	22,770	3,061
NPV of child conceived by IVF, mother aged 38–40 years (21.6% success rate)	8,673	19,212	507
NPV of child conceived by IVF, mother aged 41–42 years (12.2% success rate)	5,890	13,270	Negative
NPV of child conceived by IVF, mother aged >42 years (4.2% success rate)	Negative	Negative	Negative
Cost of IVF drugs, 50% increase	8,691	19,183	650
Cost of IVF drugs, 100% increase	7,544	16,663	Negative
Break-even cost of IVF drugs and supplies per cycle, $	3,870	8,530	1,780
Cost of pregnancy and delivery, 50% increase	9,782	21,583	2,150
Discounting rate, 0%	10,986	Negative	Negative
Discounting rate, 5%	1,544	13,907	1,826
Discounting rate, 10%	Negative	Negative	Negative

Abbreviations: IVF, in vitro fertilization; NPV, net present value.

Table S1 Input parameters in deterministic and probabilistic models

Parameter	Country	Deterministic data	Minimum meaning	Maximum meaning	Reference
GDP, $	Ukraine	3,615	2,985.5	7,600	1–3
	Belarus	6,480	5,820	16,000	1,3,4
	Kazakhstan	11,356	11,356	13,900	1,3
GDP growth, %	Ukraine	4.03	0.20	5.20	5,6
	Belarus	7.74	4.30	7.74	5,6
	Kazakhstan	7.46	1.2	8.9	5
Total tax rates as % from salaries	Ukraine	55.36	33.60	55.36	7
	Belarus	47.54	42.79	52.29	8
	Kazakhstan	31.00	31.00	37.20	9
Average monthly salary for males, $	Ukraine	379.37a	289.75	637.91	2
	Belarus	483.94a	421.49	620.14	10,11
	Kazakhstan	779.00b	598.85	1,564.53	12–14
Average monthly salary for females, $	Ukraine	301.73a	230.45	507.35	2
	Belarus	384.90a	335.22	439.22	10–12
	Kazakhstan	410.85b	315.77	824.98	13–15
Average monthly pension, $	Ukraine	129.24	104.84	145.72	2,16,17
	Belarus	219.94	99.32	228.44	11,12
	Kazakhstan	240.24	192.19	269.07	18
Average monthly unemployment support, $	Ukraine	82.02c	68.06	103.22	2,16,17
	Belarus	17.00c	13.33	20.00	19
	Kazakhstan	119.72d	95.78	143.66	20
Unemployed from working population, %	Ukraine	7.00	6.40	8.80	2,21
	Belarus	1.00	0.50	1.60	19,22
	Kazakhstan	5.20	5.20	6.60	14,23,24
Retired population working, %	Ukraine	15.00	13.50	18.00	2
	Belarus	22.00	19.80	26.40	12
	Kazakhstan	16.00	14.40	19.20	14
Retirement age males, years	Ukraine	60e	60	65	16,25
	Belarus	6e	60	65	16,25
	Kazakhstan	63e	63	65	25,26
Retirement age females, years	Ukraine	60e	60	65	16,25
	Belarus	55e	55	65	16,25
	Kazakhstan	58e	58	65	25,26
State expenditure on education, $	Ukraine	247.94	191.60	253.05	2,27
	Belarus	291.60	336.96	453.60	22,28
	Kazakhstan	352.65	340.68	681.36	24,28
State expenditure on health care, $	Ukraine	231.49	231.49	253.05	29
	Belarus	362.88	362.88	453.80	29
	Kazakhstan	488.31	488.31	794.92	29
Fertility success rate, %		31.9	31.20	32.5	30
Discounting, %		3.00	–	–	31

Notes:

a Assumption 22.8% difference in male/female salaries according to state statistics report (Ukraine);²

b assumption 61.9% difference in male/female salaries according to state statistics report (Kazakhstan);¹⁴

c average monthly support received for 12 months;

d average monthly support received for maximum 4 months (under the law “On obligatory social insurance” of the Republic of Kazakhstan);

e assumed that retirement age will not be lowered from existing.

Abbreviation: GDP, gross domestic product.

State Committee of Statistics of UkraineSocial protection of the population of Ukraine. The compendium of statisticsUkrainian2011

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Agency of the Republic of Kazakhstan on StatisticsAnalytical report Russian. Available from: http://www.stat.kz/publishing/DocLib1.docAccessed December 08, 2013

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