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Shared-risk IVF program:
There are some programs advertising shared risk IVF programs.
For example one IVF center advertises that for $30,000 they
guarantee a live pregnancy within 6 cycles of IVF or you get your
money back. If you read
the fine print carefully it is not a refill on all money spent but
generally the money spent for oocyte retrieval, embryo development
and embryo transfer.
The American Society for Reproductive Medicine (ASRM) and
SART considers the shared risk groups as ethical.
We however do not think so.
Our belief is that it falsely makes the consumer have
possible false confidence in that center and the consumer believes
this must be a great IVF center if they are willing to completely
return at least the retrieval, embryo development, and transfer fee.
First people must realize that the IVF center does not
guarantee that they will accept everyone into the program.
In fact they only accept those women who have a good chance
of quick success, i.e., young, adequate egg reserve, so previous
failure to conceive with IVF, etc.
It is a good advertisement for the IVF clinic because even if
they reject most couples making the initial consult, hopefully they
can convince them to still use their IVF center.
But for those accepted into the program is it a good deal?
We at Cooper do not think so and that it is not ethical because the
consumer does not realize that the majority will spend much more
money than they would have if they just had IVF performed without
the shared risk program.
For example full IVF-ET cycle at Cooper cost ~6,000 for
oocyte retrieval, embryo development and transfer.
“Good candidates” should have about a 50% success rate with
fresh or frozen embryo transfer.
So if we accepted $30,000 versus our $6,000 for the first
hundred patients:
1)
50 would be expected to be pregnant first cycle
Normal expense $6000, shared cost $30,000
Five times more money!!
2)
One should expect at least 2 frozen embryo transfers for the
first retrieval.
Of the fifty remaining patients who did not conceive on the
first cycle 25 should be
pregnant on the first frozen embryo transfer.
Normal expense $6,000 for first retrieval plus $3,000 for
frozen ET = $9,000
But these 25 with shared risk pays $30,000.
3)
Of the remaining 25 patients 12 should conceive with the next
frozen ET with a cost of
$6,000, $3,000, and $3,000 with a total of $12,000 vs.
$30,000 for shared risk.
4)
Thirteen patients would be expected to now undergo a second
oocyte retrieval.
Six of these 13 should conceive.
Total cost $6,000, $3,000, $3,000, and $6,000 with a total of
$18,000. The shared risk
payment - $30,000.
5)
3 of the 7 remaining would be expected to conceive with the
next frozen ET.
Total cost for these 3 - $6,000, $3,000, $3,000, $6,000 and
$3,000 - $21,000
Cost for shared risk $30,000
6)
2 of the remaining 4 get pregnant with the last frozen ET
(total 6 cycles) add another
$3,000
Total cost $24,000 vs. $30,000 for shared risk
7)
Only 2 patients would benefit from the shared risk – they
would have paid us $24,000
with no baby but they get there money back.
Would shared risk be a good deal for Cooper?
You bet! For
these hundred patients Cooper would have received $2,940,000 with
shared risk (98X30,000) but would have only received a total of:
50x$6,000
$300,000
25x$9,000
$224,000
12x$12,000
$144,000
6x$18,000
$108,000
3x$21,000
$63,000
2x$24,000
$48,000
2x$24,000
$48,000
_______________________
$931,000
Thus at Cooper we would make three times the profit by
offering shared risk but it is not fair to the patients.
Of course you could argue that this difference is saving for
the patient is at least partially related to our low initial cost.
What if the center charged $12,000 for a fresh transfer and
$4,000 for frozen.
Again first 50 patients conceiving first cycle payed:
$12,000 each vs. $30,000
Second 25 women:
$16,000 vs. $30,000
Next 12 patients:
$30,000 vs. $30,000
Next 6 women:
$32,000 vs. $30,000
Next 3 women:
$35,000 vs. $30,000
Next 2 women:
$39,000 vs. $30,000
Next 2 women:
$43,000 vs. zero
Even with their shared risk program the total money that
would have become paid by these women would have been:
12,000x50=$600,000
16x25-$400,000
12x30=$360,000
6x32=$192,000
3x35=$115,000
2x39=$78,000
____=$86,000
______________
$1,831,000
So if the facility offering shred risk had just charged the
patients for each cycle they would have received $1,831,000 with
shared risk even giving back $60,000 ($30,000 each for the 2 not
conceiving). They would
receive:
100x$30,000 = $3,000,000
minus $60,000
Total $2,940,000
So the facility by accepting the risk makes $1,000,000 more
from 100 patients and gains extra customers who just do not qualify
for the program but stays with them.
But the consumer pays $1,000 more.
So that by entering the shared risk program they pay the
facility an average of $10,000 more than if the patient just had
regular services at that facility.
And compared to our own facility if we offered the shared
risk program each patient would pay $20,000 more than they had to.
This is why we do not think it is ethical and do not
encourage or offer this program.
Nevertheless since these details have been disclosed if
someone wants us to do the same shared risk program we will give
them the same deal for $20,000
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MATERIAL CONTAINED WITHIN THIS SITE © 2003 BY COOPER
INSTITUTE FOR REPRODUCTIVE HORMONAL DISORDERS, P.C.
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