Mark Henderson, Science Editor of The Times
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IVF clinics will have to give their patients full details of all the likely costs of treatment before they start to provide it, under new regulations announced yesterday by the Government’s fertility watchdog.
The Human Fertilisation and Embryology Authority (HFEA) is to insist that clinics provide costed treatment plans after every couple’s early consultations, as a condition of licensing them to practice.
The new measures are designed to protect the 70 per cent of IVF patients who pay an average of about £3,500 for private therapy, following widespread complaints that they are hit with unexpected fees after beginning their treatment.
Charges for drugs and diagnostic tests, some of which have little evidence that show them to be effective, can sometimes increase the total cost of a cycle of IVF to £8,000 or more.
Many patients, however, are told only about the basic costs of therapy when they agree to start, and later feel obliged to pay the extra fees as they have already spent thousands of pounds on their efforts to start or add to a family.
The HFEA’s decision to make costed treatment plans mandatory follows a survey of the regulator’s Fertility Views advisory panel, which is made up of 1,000 current and former IVF patients.
It found that 85 per cent of these patients had paid for treatment themselves, yet only 20 per cent of these were given a costed plan at the outset that was tailored to their needs. Others were shown only a general price list, or were told in conversation about likely costs.
More than a quarter of patients had had to pay additional fees that they had not originally expected, and 88 per cent said that they should have liked to have been given a full costed schedule of likely drugs, tests and procedures before deciding to go ahead with IVF.
The HFEA said it accepted that the costs of drugs can be difficult to assess before IVF treatment begins, as this will depend on factors such as dose, length of prescription and changes to medication that is poorly tolerated or ineffective.
Nevertheless, it will ask clinics to give patients a guide price, to warn them about maximum likely costs, and to inform patients promptly about changes to the drugs bill and other additional costs.
The HFEA cannot legally cap or regulate private IVF clinics’ fees, but it can insist that particular information is given to patients as a condition of licensing.
Alan Doran, the HFEA’s interim chief executive, said: “Going through treatment for infertility is very stressful and we know that one of the key concerns for patients is how much it will cost.
“We know that some clinics have excellent ways of clearly explaining treatment costs. Fee structures and the way prices are explained can vary greatly from clinic to clinic, so we will be seeking out best practice and using it to help us develop guidance for the rest of the sector.
“The HFEA can work with clinics to help them ease patients’ concerns about cost by ensuring that they are empowered with clear and reliable information.”
The move comes amid increasing controversy over the NHS’s poor provision of IVF, and alleged conflicts of interest in the private sector.
Though the National Institute for Health and Clinical Excellence recommends that three cycles of treatment should be free for women aged under 40, no NHS trusts have met this target and many fail even to offer the single free cycle that the Government asks them to provide.
This drives many patients to seek treatment at private clinics, which now form an industry with an annual turnover estimated at £500 million. In 2005, 41,932 cycles of treatment were given to 32,626 women, and 70 per cent of these are thought to have been performed privately.
Concern about conflicts of interest have mounted because private clinics both advise patients on appropriate treatments and profit from them. Critics such as Lord Winston, the former head of Hammersmith Hospital’s IVF unit, have accused some clinics of providing unnecessary or ineffective treatments and investigations.
Susan Seenan, of the patient charity Infertility Network UK, said: “The whole infertility process is extremely stressful and we welcome any measures which can help alleviate some of this stress. Being given accurate information at the outset about all aspects of their treatment, including the costs involved will help patients make informed choices on the best course of treatment for them and ensure that they are not faced with additional unexpected costs part way through a cycle.”
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