E-Paper
Insured fertility care as key to the crisis
This article is authored by Shobhit Agarwal, CEO, Nova IVF Fertility.
Fertility care in India is largely socially under-recognised, whilst it is an important clinical issue. Based on recent numbers, between 10-15% of the reproductive-age Indian couples suffer from infertility, corresponding to around 27-30 million couples needing IVF treatment. Additionally, the WHO’s guideline on infertility report also suggests increased cases of male infertility and metabolic disorders such as PCOS, and a rise in endometriosis leads to increased demand in IVF care. Unfortunately, despite the increasing need for infertility treatments, access to them varies considerably based on one's financial situation.
The cost of treatment remains a significant issue, even today. IVF and advanced fertility treatments cost patients about ₹1.5 to 2.5 lakh per single cycle. However, multiple procedures may be necessary, making the cost unaffordable for many. In addition, there is a gap in early diagnosis and awareness, with many patients seeking care at advanced stages when interventions become more complex and expensive. Social stigma and lack of structured counselling support also contribute to delayed treatment-seeking behaviour. This contradicts global tendencies where the World Health Organization (WHO) recognises infertility as a disease, thereby giving it equal status as other conditions treated within the framework of medical insurance.
Considering both policy and regulation aspects, India cannot treat fertility care in an elective manner, rather we should integrate it into mainstream insurance. Industry bodies such as the Insurance Regulatory and Development Authority of India (IRDAI) must introduce inclusion mandates that encourage people to consider fertility treatments without feeling burdened.
Models like partial funding, co-payment systems, and capping on the number of cycles could strike a balance between cost considerations and risk factors for the insurer, while still making access easier for the patient.
Simultaneously, some initial steps have been taken by corporates in India. An increasing number of multinational companies and new-age startups are providing fertility care as part of their employee benefit schemes, realising that reproductive care is not only directly connected to work but is an essential aspect of gender equality and retaining talent.
Affective tax incentives, too, remain underutilised. While certain medical expenses qualify for deductions, fertility treatments are not optimally structured within existing tax frameworks. Rationalising this could reduce the effective cost burden for individuals and encourage earlier intervention.
On a global level, there are several nations that have set up successful examples in the context of which India can learn. Europe as well as certain states in the US, have included or subsidised IVF treatments and shown how effective and possible structured inclusion could be. It is also important to remember that not all cases of infertility involve such treatments. An inclusive model needs to have the provision for diagnostics and counselling.
To achieve this objective, a multifaceted strategy with proper coordination between all parties involved is required. Concerned policy and developmental regulators, insurance agencies, employers, along with healthcare organisations, are they key pillars to this and each have a different role to play in creating an effective structure. In recent decades, India has come quite far when it comes to maternal and reproductive health. Now is the time when India moves towards making fertility care not just a choice, but a basic requirement for a good healthcare system that is equitable and inclusive.
India’s demographic dividend has often been described as a treasure trove of economic progress, however with India’s Total Fertility Rate (TFR) dropping below the replacement level of 2.1 to 1.9, low birth rate is the next crisis we are tackling. Few states in the South of India, are already taking in measures and incentivising to have children. Countries with dangerously low birth rate like Japan, South Korea have been combating the crisis by bringing in ART procedures under national health insurance scheme. Rather than questioning if IVF treatments should be a part of the insurance, the question to ask is can we really afford not covering these treatments in the long-run?
(The views expressed are personal)
This article is authored by Shobhit Agarwal, CEO, Nova IVF Fertility.
