In vitro fertilization (IVF) is a vital option for many individuals and couples struggling with infertility. However, the costs associated with IVF, particularly medications, have surged dramatically in recent years.
According to Tori Marsh, MPH and Director of Research at GoodRx, IVF medication prices have risen by 84 percent since 2014.
The rising costs of IVF medications and the unequal access to insurance coverage disproportionately impact certain demographic groups. According to Dr. Marsh, women with lower incomes and those living in medically underserved areas—particularly Black and American Indian/Alaskan Native women—are often at a greater disadvantage. These populations face additional barriers to accessing quality healthcare and insurance coverage, making it more challenging for them to afford fertility treatments like IVF.
Why Are IVF Medication Prices Increasing?
Several factors have contributed to the sharp rise in the cost of IVF medications. One of the primary reasons, as Dr. Marsh explains, is the complexity of the drugs themselves. Many IVF medications are biologics, which are derived from living cells and are thus more expensive to manufacture. Unlike simpler synthetic drugs, biologics require intricate processes to develop, and this cost is passed on to the consumer.
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Additionally, many of the medications used during IVF remain under patent, meaning no generic alternatives are available. Without generics, patients have no access to more affordable options, making these medications more expensive.
Dr. Marsh further points out that the most significant price hikes have been seen in the stimulation phase of IVF, where the goal is to generate as many eggs as possible for retrieval. This phase involves some of the most expensive medications, making it a crucial area where patients feel the financial strain.
How Does Your State Affect IVF Costs?
One of the major contributors to the disparity in IVF costs across the U.S. is the lack of uniform insurance coverage for fertility treatments. Currently, only 17 states have laws requiring some level of insurance coverage for fertility treatments, and even within these states, coverage can vary widely.
“The scope of coverage can vary a lot—for example, some may help with a diagnosis but won’t cover actual IVF treatment, or they might limit how many IVF cycles are covered. Or, restrictions like step therapy or certain health requirements can make it difficult to access the coverage fully,” Dr. Marsh shares.
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For patients living in states without fertility coverage mandates, the costs are often entirely out-of-pocket, further exacerbating the financial burden of IVF.
If you are navigating these challenges, Dr. Marsh recommends exploring alternative options such as copay cards, patient assistance programs, or GoodRx to reduce out-of-pocket costs. By understanding the specific requirements and limitations of your insurance plan, you can better strategize and plan your fertility treatments.
How to Make IVF Medications More Affordable
If you are struggling to afford IVF medications, there are several potential avenues for cost savings. Some pharmaceutical manufacturers offer patient assistance programs, which may provide medications at a reduced price or even for free to those who qualify. Additionally, GoodRx can be a valuable resource for finding discounted prices on IVF medications. Dr. Marsh notes that GoodRx offers discounts of up to 43 percent on fertility treatments, making it a useful tool for patients seeking to lower their medication costs.
“GoodRx offers discounts on both generic and brand-name medications used throughout every phase of the IVF process. Just head to the GoodRx app or visit the website and search for the IVF medication you’ve been prescribed. After you select the pharmacy with the lowest price, don’t forget to have your GoodRx coupon ready to show at the pharmacy counter when you pick up your prescription. The coupon can help you gain substantial savings in some cases,” Karla Robinson, MD, Medical Editor at GoodRx adds.
Alternatives to IVF
For many individuals and couples, deciding whether IVF is the right treatment involves weighing the high cost against alternatives like intrauterine insemination (IUI). As Dr. Robinson explains, IUI is less invasive and less expensive than IVF, making it an appealing first option for many.
“This method typically costs between $500 and $4,000, compared to IVF, which can cost around $20,000 per cycle,” Dr. Robinson notes.
However, for some women, such as those with blocked fallopian tubes or a history of health issues, IUI may not be viable, and IVF becomes the best course of action.
When planning for IVF, it’s essential to consider the financial implications beyond a single cycle. “There are several options available to help you save on your fertility treatments, but I would first get a sense of how much IVF is going to cost you. You can start by contacting your health insurance provider to see if your plan covers IVF or any alternative treatments and ask them about out-of-pocket expenses, prior authorizations, eligibility criteria and coverage limitations. When considering costs, it’s also important to factor in that you may need more than one IVF cycle. From there, start putting together a budget to determine how much you need to start saving. It can be helpful to set up a dedicated savings account where you can set aside portions of your income, and I would also recommend asking your doctor about payment plan options,” Dr. Robinson adds.
Alternative Fertility Treatments and Affordable Care Options
If you are struggling to afford traditional fertility treatments like IVF, there are alternative methods to explore. Dr. Robinson suggests that optimizing overall health can sometimes improve fertility.
“Making sure you are eating a well-balanced diet, exercising regularly, eliminating smoking and decreasing stress can go a long way to improving overall health and wellness. It’s also a good idea to make sure any medical conditions you may have are well managed. Talk with a healthcare professional about any underlying conditions or medications you’re taking, which may be impacting your fertility, and consider making some treatment plan changes if necessary,” Dr. Robinson advises.
Additionally, you may be able to participate in clinical trials, where the cost of fertility treatments is covered as part of the study. IVF grants through nonprofit organizations are also available to help offset the costs for eligible individuals, providing another avenue for more affordable care.
“Check your state laws for additional coverage you may have access to. There are also IVF grants available through some nonprofit organizations. Some income and residence restrictions apply, but they’re worth looking into. I would also recommend that you shop around. Different fertility clinics offer different rates, packages, and payment plans. You may also want to consider participating in a clinical trial. Research is ongoing on new fertility treatments, and you may have the cost of your fertility treatment covered if you’re enrolled in a study,” Dr. Robinson concludes.
