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Increased depot medroxyprogesterone acetate use increases family planning program pharmaceutical supply costs
1University of Washington School of Medicine, Seattle, WA, USA.
Contraception
|May 23, 2001
Summary
Depot medroxyprogesterone acetate use has increased, driving up family planning program costs. Higher prices for this injection contraceptive, unlike discounted oral contraceptives, strain program budgets and access.
Area of Science:
- Family Planning
- Reproductive Health
- Pharmaceutical Economics
Background:
- Oral contraceptives (OCs) and depot medroxyprogesterone acetate (DMPA) are key family planning methods.
- Programmatic cost-effectiveness of contraceptive choices is crucial for service provision.
Purpose of the Study:
- To measure contraceptive use rates and compare acquisition costs of DMPA versus OCs.
- To assess the impact of changing use trends on pharmaceutical acquisition costs in a family planning program.
Main Methods:
- Comparison of vendor invoice costs for DMPA and OCs across 1992, 1994, and 1999.
- Analysis of client demographic and visit type data.
- Inquiry to a local pharmaceutical chain regarding acquisition costs.
Main Results:
- DMPA use increased from 3% to 17%, while OC use decreased from 45% to 40% between 1992 and 1999.
- DMPA cost ($4.75/28 days) is four times higher than OCs ($1.35/package).
- Significant discounts for OCs (20-fold) contrast with limited discounts for DMPA (2.8-fold), increasing overall program expenditure.
Conclusions:
- Increasing DMPA popularity and its higher, less-discounted cost significantly elevate pharmaceutical acquisition expenses.
- The high cost of DMPA, potentially due to lack of generic competition, threatens the program's ability to offer this effective contraceptive method.
- Cost-saving strategies or increased discounts for DMPA are needed to ensure continued access for clients.
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