title: The price of emergency contraception in the United States: what is the cost-effectiveness of ulipristal acetate versus single-dose levonorgestrel?
abstract: BACKGROUND
  Ulipristal acetate (UPA) is a novel form of emergency contraception (EC) that appears to be more effective than the prevailing method, single-dose levonorgestrel (LNG). This study examines the cost-efficacy of UPA compared with LNG.
  
  
  METHODS
  A decision-analytic model was developed to compare the cost-effectiveness of UPA versus LNG in preventing unintended pregnancy when taken within 120 h of unprotected intercourse. Univariate and bivariate sensitivity analyses, as well as Monte Carlo simulation and threshold analyses, were performed.
  
  
  RESULTS
  Utilizing UPA instead of LNG would result in 37,589 fewer unintended pregnancies per 4,176,572 estimated US annual EC uses (UPA 54,295 pregnancies; LNG 91,884 pregnancies) and a societal savings of $116.3 million annually. Cost-effectiveness acceptability curve analyses suggest a 96% probability that UPA is more cost-effective at a willingness to pay $100,000 per quality-adjusted life year.
  
  
  CONCLUSIONS
  UPA is cost-effective in preventing unintended pregnancy after unprotected intercourse. Efforts should be promoted to increase access to UPA.
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA. bayerl@ohsu.edu
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Bayer
authors.forename: Alison B
authors.initials: AB
authors.lastname: Edelman
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
authors.forename: Maria I
authors.initials: MI
authors.lastname: Rodriguez
mesh_terms: D044363:Contraception, Postcoital / Q000191:economics*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000191:economics*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage / Q000191:economics*; D009010:Monte Carlo Method; D009649:Norpregnadienes / Q000008:administration & dosage / Q000191:economics*; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D014481:United States
chemical_list: D003271:Contraceptive Agents, Female; D009649:Norpregnadienes; D016912:Levonorgestrel; C555622:ulipristal acetate