This study demonstrates that it is cost effective to use IVF with PGD to prevent the birth of a child with cystic fibrosis (CF). The cost benefit evaluates the medical costs not the human costs which are significant. Importantly, the benefit extends to at least a mother’s age of 40.
IVF/PGD comes with what appears to be a large price tag. However, the cost of having an affected child is far greater. Couples who are at risk for having a child with CF should seriously consider using technology to avoid passing the disease to their children.
One must also begin wondering if the same cost benefit analysis would apply to other genetic diseases. I think we all await those studies.
A cost-benefit analysis of preimplantation genetic diagnosis for carrier couples of cystic fibrosis
Lynn B. Davis, M.D., M.S., Sara J. Champion, M.S., Steve O. Fair, M.B.A., Valerie L. Baker, M.D., Alan M. Garber, M.D., Ph.D.
Fertility and Sterility Volume 93, Issue 6, Pages 1793-1804 (April 2010)
Received 25 June 2008; received in revised form 21 November 2008; accepted 10 December 2008. published online 12 May 2009.
Objective: To perform a cost-benefit analysis of preimplantation genetic diagnosis (PGD) for carrier couples of cystic fibrosis (CF) compared with the alternative of natural conception (NC) followed by prenatal testing and termination of affected pregnancies.
Design: Cost-benefit analysis using a decision analytic model.
Setting: Outpatient reproductive health practices.
Patient(s): A simulated cohort of 1,000 female patients.
Intervention(s): We calculated the net benefit of giving birth to a child as the present value of lifetime earnings minus lifetime medical costs.
Main Outcome Measure(s): Net benefits in dollars.
Result(s): When used for women younger than 35 years of age, the net benefit of PGD over NC was $182,000 ($715,000 vs. $532,000, respectively). For women aged 35–40 years, the net benefit of PGD over NC was $114,000 ($634,000 vs. $520,000, respectively). For women older than 40 years, however, the net benefit of PGD over NC was -$148,000 ($302,000 vs. $450,000, respectively).
Conclusion(s): Preimplantation genetic diagnosis provides net economic benefits when used by carrier couples of CF. Although there is an upper limit of maternal age at which economic benefit can be demonstrated, carrier couples of CF should be offered PGD for prevention of an affected child.