Evidence map›Paper›PMID 40671365›Full record

ArticleHealth policy and planning2025

Willingness to pay for assisted reproductive technologies among individuals with infertility in China.

Chaofan Li, Hongbin Cong, Stephen Jan, Lei Si, Ling Geng, Shunping Li

Abstract read
In one paragraph

Article in Health policy and planning, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chaofan LiDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.ORCID 0000-0001-6238-1257
Hongbin CongState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
Stephen JanThe George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, 300 Barangaroo Ave, Sydney, NSW 2000, Australia.
Lei SiSchool of Health Sciences, Western Sydney University, 183 Narellan Road, Campbelltown, NSW 2560, Australia.
Ling GengState Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.ORCID 0009-0004-7813-3521
Shunping LiDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.ORCID 0000-0001-8144-6220

Funding

Ministry of education of Humanities and Social Science project 22YJCZH076National Natural Science Foundation of China 72204146Shandong Provincial Natural Science Foundation ZR2021MG010Shandong Provincial Natural Science Foundation ZR2022QG018
6 · The paper itself

Abstract

Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs) rarely covers ART services. In China, where birth rates are declining, willingness to pay (WTP) can inform insurance reimbursement policies by reducing out-of-pocket expenses. However, there is no consensus on WTP thresholds for assessing the cost-effectiveness of fertility treatments in LMICs. This study aimed to assess WTP for ART among individuals with infertility in China. Data were obtained from a cross-sectional survey conducted at five hospitals across different geographical and socioeconomic regions in China. Individuals with infertility were recruited using a quota sampling method. A contingent valuation method was employed, with three hypothetical WTP scenarios developed to present detailed information on the success rates, costs, and the treatment processes of in vitro fertilization (IVF), artificial insemination (AI), and preimplantation genetic testing (PGT). A total of 570 individuals with infertility participated in the survey [94.4% female; mean (standard deviation) age: 33.0 (4.7) years]. The sampled respondents were willing to pay renminbi (RMB) 30 163 [$4259, 95% confidence interval (CI): RMB 29 650-30 675] for IVF, RMB 6046 ($854, 95% CI: RMB 5987-6106) for AI, and RMB 47 234 ($6669, 95% CI: RMB 46 435-48 033) for PGT. These WTPs were equivalent to 0.34, 0.07, and 0.53 times the GDP per capita in China, respectively. Older age and male-factor or unexplained infertility were significantly associated with lower WTP (P < .05), while higher education and patient-physician communication about costs were positively associated with WTP (P < .05). These findings suggest that public health insurance schemes should establish appropriate cost-effectiveness thresholds and reimbursement ceilings for ART to improve affordability and access. Incorporating patient-physician communication about cost into clinical practice may facilitate shared decision-making and potentially increase patients' perceived value of ART.

Indexed as

Financing, PersonalHealth ExpendituresInfertilityReproductive Techniques, AssistedAdultChinaCost-Benefit AnalysisCross-Sectional StudiesFemaleFertilization in VitroHumansMaleSurveys and Questionnaireshealth economicspatientswillingness to pay

Identifiers

PMID40671365
PMCPMC12448910

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.