Burden of Disease in Asian Countries and the use of Disability-Adjusted Life-Years and Quality-Adjusted Life-Years

Abstract

Objectives: The potential high-unintended pregnancy rates have resulted in great productivity loss in China. Several contraceptive methods have been introduced by both the providers and the woman themselves to reduce the unintended pregnancy rates.A cost-benefit analysis on various hormonal contraceptive methods was performed in order to provide references for contraception selection in China. MethOds: A decision-tree model was used to compare contraception costs and effects among different contraceptive methods. All women were classified into three contraception profiles (continuation, discontinuation and switch, discontinuation and drop-out).Outcomes included no pregnancy, pregnancy with no birth and birth. All the probabilities, medical and medication data in this model were derived from the literature and interviews. Results: A comparison of total estimated yearly and cumulative costs indicated that contraceptive implants, transdermal contraceptive, extended-cycle OC, vaginal ring, and IUD were less costly, less than $281733.7 in a three-year study period. While transdermal contraceptive, extended-cycle OC and vaginal ring were not available in the Chinese market, contraceptive implants and IUD were the only two choices in China with lowest cumulative costs. The further cost-benefit analysis also demonstrated contraceptive implants as good value for money. Using contraceptive implants were proved to have the lowest cost of pregnancy from failure of $839.9, with a total cost of $26814.9, and a benefit-cost ratio of 2.2, far over 1.0. Sensitivity analysis by tornado diagrams showed that cost of pregnancies, age and proportion of discontinuation and switch might have the greatest impact on the costs and failure risks of contraceptive implants. cOnclusiOns: In order to reduce the unintended pregnancy rates, the implementation of hormonal contraception may lead to a benefit in terms of both costs and effects. And among all the hormonal contraception in the Chinese market, contraceptive implants tend to generate greater economic benefits. Note:1US dollar= 6.46 Chinese yuan.Objectives: China is a big country with a large population. Reproductive health education is not sufficient for women of childbearing age, which leads to high unintended pregnancy (UP) rate. These represent a significant cost to the health care system. This study analyzes the epidemiology and productivity loss of unintended pregnancy in China. MethOds: The study reviewed published scientific articles and policy documents related to unintended pregnancy in China. We retrieved literature from Wanfang and PubMed databases, and searched policy documents in websites of National Bureau of Statistics and National Center for Women and Children's health, China CDC. Results: Almost 10% of fertile women have UP in China each year. There are four different results of UP, including miscarriage, elective abortion, ectopic pregnancy and delivery. There are two methods of elective abortion, including operation abortion and drug abortion. The costs of operation a...