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Obligations for practitioners
Actions that should be taken by practitioners to bring down the costs for patients and health care systems:
- opting for the most cost-effective treatment. Example: IVF or IUI (Bahadur et al., 2016) - avoid unproven add-on interventions that drive up the cost (Harper et al., 2017) Examples: assisted hatching, time-lapse imaging,...
- stop the overuse of IVF and ICSI (Kamphuis et al., 2014). There is an unexplainable increase in unexplained infertility and male factor infertility.
Big problem for public support: commercialisation and the risk of overconsumption.
3. Obligations for patients
Public funding also generates obligations and restrictions for patients.
Money spend on the unneeded treatment of one patient deprives another patient of his/her needed treatment.
- accept the most cost-effective treatment (within limits)
- change behaviour and lifestyle to increase the chances of success (smoking, obesity
...)
This does not mean that these elements should function as exclusion criteria but there should at least be a real commitment on the patient’s part to do those things that increase the chances of success and thus decrease cost.
Important justice considerations: these visible and ‘objective’ features are frequently used to cut healthcare expenses.
Instance of blaming the victim.
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