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Some NHS commissioners paying twice as much for IVF

22 September 2014
Appeared in BioNews 772

Research conducted by the campaign group Fertility Fairness has uncovered significant variations in the amount that NHS Clinical Commissioning Groups (CCGs) are paying for one cycle of IVF treatment.

Fertility Fairness, formerly the National Infertility Awareness Campaign, made Freedom of Information requests that generated responses from all but one of England's 211 CCGs. The responses revealed that the price being paid by CCGs for a single cycle of IVF treatment ranges from £2,900 to £6,000.

Sarah Norcross, co-chair of Fertility Fairness and director of the Progress Educational Trust, which publishes BioNews, said: 'Our audit has revealed a picture of widespread confusion about the real cost of IVF, and illustrates the need for a national tariff to inject some parity and value into the commissioning process'.

'Cost is cited by NHS commissioners as a major barrier to complying with NICE guidance, and yet we now know that it is not even clear how much an individual cycle of IVF should cost. The discrepancies are huge, and this needs to be addressed as a matter of urgency', she added. 

CCGs currently negotiate how much they pay to the fertility clinics, who undertake much of their work in question on a localised basis. Many CCGs do not meet the guidance set out by NICE, which recommends that eligible women aged under 40 with unexplained infertility should be offered three cycles of IVF treatment on the NHS.

In fact, responses obtained by Fertility Fairness reveal a decline in the number of CCGs following the NICE guideline: just 18 percent of CCGs are offering three full cycles of IVF on the NHS - a fall from 27 percent in 2011 - and over half of CCGs (52 percent) now offer just one cycle; a marked increase from 39 percent in 2011.

One CCG, NHS Vale of York, continues to offer no funding for fertility treatment at all (see BioNews 766) and patients under this CCG must move to another area of the country if they wish to receive NHS-funded fertility treatments.

Susan Seenan, chief executive of Infertility Network UK, said: 'Access to fertility treatment in the UK still depends entirely on where you live, and patients are at the mercy of the postcode lottery'.

She added: 'Now it appears that some CCGs are apparently paying more for a cycle of NHS-funded IVF than an individual patient might expect to be charged at a private clinic. It is patients who suffer the effects of this mismanaged system. Clear guidance on costing would help CCGs to implement the NICE guidance fully and allow patients to access the treatment they need'.

NICE has included its recommendation to fund three cycles of IVF in its recent Draft Quality Standard on Fertility (see BioNews 754), which is due to be finalised in October. The statements provide a quality standard to be applied across all CCGs that highlights areas of care where improvements are needed most.

Fertility Fairness is calling for the development of a national tariff for tertiary fertility services to address the variations in cost that are currently seen across the county. It is also calling for a CCG Outcome Indicator for fertility services to emphasise the importance of NICE's earlier recommendations, among others.

SOURCES & REFERENCES
Cuts mean more women are denied IVF on the NHS
The Independent |  15 September 2014
Fertility Fairness reveals huge discrepancies in the cost of IVF to the NHS
Fertility Fairness (press release) |  9 September 2014
NHS is accused of a 'cruel betrayal' of couples by rationing IVF treatment to save money
The Guardian |  15 September 2014
Some GP commissioners pay twice as much for IVF as others, review finds
BMJ News |  11 September 2014
Women being denied IVF in NHS ‘betrayal’
The Times (subscription required) |  15 September 2014
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