Health Research Board Report: Assisted reproductive technologies: International approaches to public funding mechanisms and criteria - An evidence review

Officials in the Department of Health are currently drafting the General Scheme of legislative provisions for assisted human reproduction (AHR). In the context of drafting this comprehensive piece of legislation, the question of public funding has arisen.

In order to assist in determining how public funding for fertility treatment might potentially be provided in Ireland, in February 2016, the Health Research Board (HRB) was engaged to conduct a comprehensive review of international public funding models.

The focus of the evidence review was to provide information in relation to the following key questions:

• describe the public funding mechanisms for assisted reproductive technology operated in a number of jurisdictions?
• what are the costs and benefits associated with the public funding of assisted reproductive technology for the funder, provider and service user?
• what are the criteria for accessing publicly funded assisted reproductive technology services in a number of jurisdictions?
• what are the countries’ justifications for their criteria for accessing publicly funded assisted reproductive technology services and are these justifications supported by clinical evidence?

Throughout Europe and globally, there is great diversity in funding and reimbursement policies and practice for AHR. In responding to the questions outlined above, the HRB’s evidence review provides a detailed overview of the different funding mechanisms available, including the eligibility criteria that need to be fulfilled, in a range of countries internationally. The HRB’s evidence review states that “national policies are a hybrid of political, cultural and economic pressure combined with clinical evidence leading to a publicly acceptable or pragmatic approach to funding assisted reproductive technologies in each individual country examined”.

The HRB’s evidence review will be analysed by officials in the Department of Health in the context of considering policy options for a potential public funding model for AHR treatment.