{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:34:55Z","timestamp":1780446895196,"version":"3.54.1"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of education of Humanities and Social Science project","award":["22YJCZH076"],"award-info":[{"award-number":["22YJCZH076"]}]},{"DOI":"10.13039\/501100007129","name":"Shandong Provincial Natural Science Foundation","doi-asserted-by":"publisher","award":["ZR2021MG010"],"award-info":[{"award-number":["ZR2021MG010"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Shandong Provincial Natural Science Foundation","doi-asserted-by":"publisher","award":["ZR2022QG018"],"award-info":[{"award-number":["ZR2022QG018"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72204146"],"award-info":[{"award-number":["72204146"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs) rarely covers ART services. In China, where birth rates are declining, willingness to pay (WTP) can inform insurance reimbursement policies by reducing out-of-pocket expenses. However, there is no consensus on WTP thresholds for assessing the cost-effectiveness of fertility treatments in LMICs. This study aimed to assess WTP for ART among individuals with infertility in China. Data were obtained from a cross-sectional survey conducted at five hospitals across different geographical and socioeconomic regions in China. Individuals with infertility were recruited using a quota sampling method. A contingent valuation method was employed, with three hypothetical WTP scenarios developed to present detailed information on the success rates, costs, and the treatment processes of in vitro fertilization (IVF), artificial insemination (AI), and preimplantation genetic testing (PGT). A total of 570 individuals with infertility participated in the survey [94.4% female; mean (standard deviation) age: 33.0 (4.7) years]. The sampled respondents were willing to pay renminbi (RMB) 30 163 [$4259, 95% confidence interval (CI): RMB 29 650\u201330 675] for IVF, RMB 6046 ($854, 95% CI: RMB 5987\u20136106) for AI, and RMB 47 234 ($6669, 95% CI: RMB 46 435\u201348 033) for PGT. These WTPs were equivalent to 0.34, 0.07, and 0.53 times the GDP per capita in China, respectively. Older age and male-factor or unexplained infertility were significantly associated with lower WTP (P &amp;lt; .05), while higher education and patient-physician communication about costs were positively associated with WTP (P &amp;lt; .05). These findings suggest that public health insurance schemes should establish appropriate cost-effectiveness thresholds and reimbursement ceilings for ART to improve affordability and access. Incorporating patient-physician communication about cost into clinical practice may facilitate shared decision-making and potentially increase patients\u2019 perceived value of ART.<\/jats:p>","DOI":"10.1093\/heapol\/czaf045","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T06:27:54Z","timestamp":1752733674000},"page":"867-875","source":"Crossref","is-referenced-by-count":3,"title":["Willingness to pay for assisted reproductive technologies among individuals with infertility in China"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6238-1257","authenticated-orcid":false,"given":"Chaofan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"NHC Key Laboratory of Health Economics and Policy Research (Shandong University), 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"Center for Health Preference Research, Shandong University , 44 Wenhuaxi Road, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbin","family":"Cong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University , 44 Wenhuaxi Road, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Jan","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales , 300 Barangaroo Ave, Sydney, NSW 2000, Australia"},{"name":"The George Institute of Global Health UK, Faculty of Medicine, Imperial College London, White City Campus, London W12 0SN ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Si","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Western Sydney University , 183 Narellan Road, Campbelltown, NSW 2560 ,","place":["Australia"]},{"name":"Translational Health Research Institute, Western Sydney University , Locked Bag 1797, Penrith, NSW 2751 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7813-3521","authenticated-orcid":false,"given":"Ling","family":"Geng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University , 44 Wenhuaxi Road, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8144-6220","authenticated-orcid":false,"given":"Shunping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"NHC Key Laboratory of Health Economics and Policy Research (Shandong University), 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), 44 Wenhuaxi Road, Jinan 250012 ,","place":["China"]},{"name":"Center for Health Preference Research, Shandong University , 44 Wenhuaxi Road, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"2025091918320186900_czaf045-B1","doi-asserted-by":"publisher","first-page":"2891","DOI":"10.1093\/humrep\/deab207","article-title":"Assessing couples\u2019 preferences for fresh or frozen embryo transfer: a discrete choice experiment","volume":"36","author":"Abdulrahim","year":"2021","journal-title":"Hum Reprod"},{"key":"2025091918320186900_czaf045-B2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.tra.2017.12.010","article-title":"What is the value of a driver licence? 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