Subscribe to the BioNews newsletter for free

Login
Advanced Search

Search for
BioNews

Like the Progress Educational Trust on Facebook


 


 

Financial incentives in Australia change doctors' IVF advice

03 November 2017

By Georgia Everett

Appeared in BioNews 925

Australian bioethicists have expressed concern that the country's assisted reproductive technology (ART) industry has become increasingly motivated by profit, causing a conflict of interest.

Research published last week in Human Fertility suggested that some fertility doctors are over-selling ART treatments, commonly offering IVF to patients who do not necessarily need it, or offering repeated IVF cycles to patients where it is known that the chances of success are minimal.

Lead author Dr Brette Blakely explained that by offering IVF to those who are better suited to less invasive treatments, such as intrauterine insemination, the clinicians are attempting to 'mislead future patients who might be tempted to seek unwarranted treatment by high-reported success rates based on women who do not represent the average IVF patient'.

The study, run by researchers at Macquarie University and Sydney University, interviewed eight individuals employed in the IVF industry, including clinicians and fertility counsellors. Most participants in the study expressed a belief that commercial and financial interests impact the level of patient commitment and care from the clinician.

The conflict of interest may risk a patient's physical health as well as being and emotionally and financially draining: ovarian stimulation and egg retrieval during IVF can have harmful side effects.

Dr Blakely, a bioethicist at the Australian Institute of Health Innovation at Macquarie University, explains that 'moderate to severe ovarian hyperstimulation syndrome may occur in one to five percent of treatment cycles and this may result in significant morbidity and can, in rare cases, be fatal'.

The authors also suggested that clinicians are misusing the Medicare system, whereby women whom are eligible for IVF can received an unlimited number of subsidised cycles. By encouraging the use of these unlimited cycles, the clinician appears to be promoting an affordable treatment, but in reality patients still face substantial out-of-pocket costs while clinicians receive large fees, plus extra income from additional services.

Professor Michael Chapman, president of Fertility Society of Australia, criticised the design of the study and said that there is no evidence of clinicians over-selling ART. Chapman argued in the Sydney Morning Herald that '[the] selection of only eight specialists seems likely to be biased given there are over 150 specialists practicing in Australia, and [the researchers] admit to being 'selective' in their comments to illustrate their argument'.

While the issue was investigated on a very small scale, the researchers hope that their 'findings have important conceptual and practical implications and set the terms for a more robust professional and public discourse'.

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

11 September 2017 - by Professor Alan Trounson and Dr Karin Hammarberg 
In Australia, almost four percent of children are born as a result of assisted reproductive technologies. The comparatively high rate of ART use is in part due to costs being covered by the taxpayer-funded health insurance scheme, Medicare...
29 August 2017 - by Shaoni Bhattacharya 
Treatment costs for IVF may be coming down in Australia as a result of a price war between fertility clinics...
08 May 2017 - by Dr Jane Williams 
Australia's key body for medical research released a new set of ethical guidelines last month on the use of Assisted Reproduction Technologies with a welcome and unusual surprise: a section on conflicts of interest...
21 November 2016 - by Rikita Patel 
A number of Australian IVF clinics are potentially misleading patients about their success rates, a consumer watchdog has warned...

HAVE YOUR SAY
Be the first to have your say.

You need to or  to add comments.

By posting a comment you agree to abide by the BioNews terms and conditions


- click here to enquire about using this story.

Published by the Progress Educational Trust

CROSSING FRONTIERS

Public Conference
London
8 December 2017

Speakers include

Professor Azim Surani

Professor Magdalena Zernicka-Goetz

Professor Robin Lovell-Badge

Sally Cheshire

Professor Guido Pennings

Katherine Littler

Professor Allan Pacey

Dr Sue Avery

Professor Richard Anderson

Dr Elizabeth Garner

Dr Andy Greenfield

Dr Anna Smajdor

Dr Henry Malter

Vivienne Parry

Dr Helen O'Neill

Dr César Palacios-González

Philippa Taylor

Fiona Fox

Sarah Norcross

Sandy Starr


BOOK HERE

Good Fundraising Code

Become a Friend of PET HERE and give the Progress Educational Trust a regular donation