Fattore, Giovanni
(2008)
A cost benefit analysis of in-vitro-fertilisation in italy.
PhD thesis, London School of Economics and Political Science.
Abstract
This thesis presents a full cost-benefit analysis of In-Vitro-Fertilisation (IVF) from a societal perspective. It is based on a contingent valuation survey administered through internet to a sample of the Italian population. A referendum format and a payment scale were used to elicit willingness-to-pay (WTP) for a publicly funded program providing IVF to infertile couples. WTP was also elicited for a hypothetical situation in which the respondent was asked to imagine being infertile and willing to have a baby. Overall, results show the feasibility of using this new method of administration of contingent valuation questionnaires. Responses reveal consistent patterns and the number of inconsistent answers is limited. WTP for private use (in case of infertility) and for a public program are positively associated with income, education, being within the fertility age range and being informed about infertility and IVF. The take-it-or-leave-it format and a variant of the payment scale method result in different mean WTP estimates, but simulated and actual referendum WTP are very similar. There is evidence of an anchoring effect since the values presented in the take-it-or-leave-it question had an impact on the answers to the modified payment card questions that followed. Mean WTP estimated from the different questions are consistently above the mean cost of providing IVF, as estimated on the basis of a full costing methodology. The IVF program shows net welfare benefits under several assumptions. The study shows that the societal benefits of an IVF program mainly derives from the high WTP of a minority of citizens who tend to be the most affluent, educated and familiar with infertility and IVF.
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