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About “Money Back Guarantee” or
“Sharing Risk” Programs
As far as we can tell, all programs that market themselves by offering
a “money back guarantee,” or otherwise “sharing risk,” operate in pretty
much the same fashion. Our approach is decidedly different for two
reasons:
- We are going to completely educate you on why the odds with such
programs are skewed in favor of higher business profit margins for the
practice, as well as increased cost for you - the consumer (the
patient).
- If after reading all of the below detailed description of how such
programs work you still want to participate in a “money back guarantee”
program, we will make one available. We still think that the odds of
such a program benefiting our profit margin are much higher than the
likelihood that such a program would benefit you, the consumer - but at
least you have now made a fully informed choice.
Description of How Such Programs Work
- The profit margin. Typically, in these programs, the
fewer cycles an enrolled patient needs to get pregnant, the more money
the clinic makes. The goal of every such program therefore is to
maximize the likelihood of a successful first cycle. Here's why:
Illustrated below are the approximate profit margins for a clinic if the
patient is successful in the first, second, or third IVF cycle.
It should be noted that drug expenditures are not even a part of
these programs and that the “fertility drug” costs run to many, many
thousands of dollars.
Success in IVF cycle #1: Program receives 235% of normal fee.
Success in IVF cycle #2: Program receives 117% of normal fee.
Success in IVF cycle #3: Program receives 78% of normal fee.
- Who qualifies? It is highly unlikely in any program
that every patient will qualify for inclusion. More likely 80-90% will
not. Ovarian reserve (egg supply and quality) and age are hugely
important predictors of likelihood of success in a given cycle. If you
are under 38 and have normal ovarian reserve, you are probably eligible
for these programs. Why? ... Because you are the least likely to need
it, meaning the highest likelihood that a program will make a larger
than normal profit. On the other hand, if the converse is true; you are
38 or older, or have decreased ovarian reserve, and therefore could
really benefit from such a program - you are not eligible to
participate, ours included. Usually, the odds of benefit would then be
in your favor, meaning lower profit margins for the clinic, and no
clinic wants that. Every program uses a somewhat different approach to
assessment of ovarian reserve, but all programs do assess it. Response
to stimulation with IVF drugs is the very best way currently known to
test ovarian reserve. Therefore, programs typically reserve the right to
stop the couple from completing the whole package at the clinic's
discretion “for any reason” including, of course, a poor response to the
stimulation drugs.
- Donor egg. The situation is even more skewed with donor
eggs, which have the highest IVF success rates of all. For example, with
our current world class donor success rates, it is exceedingly unlikely
that three fresh cycles would be necessary to accomplish an ongoing
successful pregnancy. This, of course, makes it even more likely that
you, the consumer, will overpay and that the clinic will reap an even
higher profit margin.
- Summary. We prefer that you pay only for the treatments
that you need, in other words fee for service. While some couples do
need more than one cycle with IVF or ICSI, our ability to freeze
good-quality embryos (if available) with every fresh cycle reduces the
need for multiple fresh cycles in patients with good ovarian reserve.
Replacement of cryopreserved embryos is much cheaper and simpler than a
fresh cycle.
On the other hand, if after reading all of this you still want to
pursue a “money back” approach, make an appointment with us. We will
assess ovarian reserve, discuss your options with you, give you all the
“fine print details” about our own “money back” program, and sign you up
if you are eligible. After all, at that point, you will be a fully
informed consumer having been told that the odds are high that you will be
increasing our profit margin in exchange for a “guaranteed” outcome.
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