McGill Journal of Medicine (Jul 2020)
Delisting Full Coverage for In Vitro Fertilization in Quebec
Abstract
On 28 November 2015, the Quebec government withdrew full coverage for its assisted procreation program that had been previously covered since 2010. The previously approved legislation under Bill 26 aimed to decrease neonatal intensive-care unit costs associated from multiple birth pregnancies and to increase the number of live-births in the province by funding up to six natural in vitro fertilization (IVF) cycles and implementing a single-embryo-transfer (SET) policy. One factor that contributed to delisting IVF services in Quebec was Quebec’s Commission of Health and Well-Being’s report that concluded that IVF services costed $63 million/per year and resulted in 1300 births/per year. Taken within the larger context of Quebec’s goal to optimize financial ressources within the healthcare system and to reduce the province’s growing debt in 2015, the government withdrew fully-funded IVF services, embryo storage and drug costs and imposed stricter criteria on who could access IVF based on a woman’s age. The government provided tax credits based on a person/couples income, again based on specific criteria. Since implementation of Bill 20, IVF rates have dropped dramatically within the province and multiple-birth pregnancies are on the rise once more. Ultimately, while delisting IVF services in Quebec provided cost-savings in the province’s budget, the law poses serious setbackts to individuals that cannot afford out-of-pocket payments and raises ethical concerns regarding infertility as a medical condition. The newly elected government in 2018 is currently studying the possibility of reinstating full coverage of oneIVF cycle by 2020.
