Epidemiological disease burden and annual, nationwide health insurance treatment cost of female infertility based on real-world health insurance claims data in Hungary

Abstract Background: Infertility affects more than 50 million couples worldwide, resulting in a significant burden on individuals and society. Its prevalence ranges from 8-12% among developed countries. The growing number of patients poses an increasing challenge to the healthcare system and its funding. Our quantitative, descriptive, and cross-sectional study aims to analyze the prevalence and annual nationwide health insurance treatment cost of female infertility in Hungary in 2019. Methods: We used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHFIA). The number of patients, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs by age group were evaluated. Infertility was determined according to the World Health Organization International Classification of Diseases codes (N.97.0, N97.1, N97.2, N97.3, N97.4, N97.8, N97.9) and the utilization of each healthcare service type. During the study descriptive statistics, correlation analysis and ANOVA were used. Results: In 2019, the NHIFA spent a total of 7.2 billion HUF (22.2 million EUR) on female infertility treatment in Hungary. The most significant costs were related to inpatient care (4.1 billion HUF, 12.7 million EUR). The highest number of patients and prevalence (33,151 women, 650.4 per 100,000 women) were found in outpatient care. In inpatient care, the prevalence is substantially lower (206.7 per 100,000 women). Female infertility, regardless of its type, mainly affects patients in the 30-39 age group (number of patients: 18,156 women). The average annual health insurance expenditure per capita was 1,083 EUR. Conclusions: Reproductive health education, prevention, and medical screening play an inevitable role in the early stages of reproductive life to reduce the risk of infertility and decrease the costs of treatment.