Babies born after ART treatment cost more than non-ART babies: a cost analysis of inpatient birth-admission costs of singleton and multiple gestation pregnancies

BACKGROUND: Currently, about one-third of infants born after assisted reproductive technology (ART) worldwide are twins or triplets. This study compared the inpatient birth-admission costs of singleton and multiple gestation ART deliveries to non-ART deliveries. METHODS: A cohort of 5005 mothers and 5886 infants conceived following ART treatment were compared to 245 249 mothers and 248 539 infants in the general population. Birth-admission costs were calculated using Australian Refined Diagnosis Related Groups and weighted national average costs (20032004 euro). RESULTS: ART infants were 4.4 times more likely to be low birthweight (LBW) compared with nonART infants, translating into 89% higher birth-admission costs (sic)2832 and (sic)1502, respectively). ART singletons were also more likely to be LBW compared with non-ART singletons, translating into 31 % higher birth-admission costs (sic)1849 and (sic)1415, respectively). After combining infant and maternal admission costs, the average cost of an ART singleton delivery was (sic)4818 compared with (sic)13 890 for ART twins and (sic)54 294 for ART higher order multiples. Findings were not sensitive to changes in casemix. CONCLUSIONS: The poorer neonatal outcomes of ART singletons compared with non-ART singletons are significant enough to impact healthcare resource consumption. The high costs associated with ART multiple births add to the overwhelming clinical and economic evidence in support of single embryo transfer.