Background: Assisted reproduction is one of the health services currently being considered for possible limitation or exclusion from the public health services portfolio in Spain. One of the main reasons claimed for this is the impact on the budget for pharmaceutical expenditure. Objective: The objective of this study was to assess the significance of the pharmaceutical costs of assisted reproduction in Spain. Methods: This study focused on medical practice in Spain, and is based on the opinions of experts in assisted reproduction and the results provided by professional societies' publications. The reference year is 2012 and the setting was secondary care. We have included all existing pharmaceutical modalities for assisted reproduction, as well as the most common drug for each modality. We have considered the pharmaceutical cost per cycle for artificial insemination, in vitro fertilisation with or without intracytoplasmic sperm injection (IVF-ICSI), and cryotransfer and donated fresh oocytes reception. Results: In Spain, artificial insemination has a pharmaceutical cost per cycle of between ?69.36 and ?873.79. This amounts to an average cycle cost of ?364.87 for partner's sperm and ?327.10 for donor sperm. The pharmaceutical cost of IVF-ICSI ranges between ?278.16 and ?1,902.66, giving an average cost per cycle of ?1,139.65. In the case of cryotransfer and donated fresh oocytes reception, the pharmaceutical cost per cycle is between ?22.61 and ?58.73, yielding an average cost of ?40.67. The budgetary impact of pharmaceutical expenditure for assisted reproduction in Spain for the year 2012 was estimated at ?98.7 million. Conclusion: In Spain, the total pharmaceutical cost of assisted reproduction is substantial. According to our results, we can say that about 29 % of the total pharmaceutical expenditure for assisted reproduction techniques is funded by the National Health System and the rest represents 2.4 % of the total annual out-of-pocket family expenditure on drugs.
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