Cost effectiveness of contraceptives in the United States.
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.


CONCLUSIONS
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.
Trussell
James
J
Office of Population Research, Princeton University, Princeton, NJ 08540, USA. trussell@princeton.edu
Lalla
Anjana M
AM
Doan
Quan V
QV
Reyes
Eileen
E
Pinto
Lionel
L
Gricar
Joseph
J
D003270:Contraceptive Agents / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000191:economics*; D016912:Levonorgestrel / Q000191:economics*; D008390:Markov Chains; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D014481:United States; D014659:Vasectomy / Q000191:economics*
D003270:Contraceptive Agents; D016912:Levonorgestrel