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Cost effectiveness of contraceptives in the United States
James Trussell1, Anjana M Lalla, Quan V Doan
1Office of Population Research, Princeton University, Princeton, NJ 08540, USA. trussell@princeton.edu
Background:
The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer's perspective.
Methods:
A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates.
Results:
Any contraceptive method is superior to "no method". The three least expensive methods were the copper-T intrauterine device (IUD) (US$647), vasectomy (US$713) and levonorgestrel (LNG)-20 intrauterine system (IUS) (US$930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy and plan disenrollment rates.
Conclusion:
The copper-T IUD, vasectomy and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy and time horizon are influential factors that determine the overall value of a contraceptive method.
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