Cost-effectiveness of emergency contraceptive pills in the public sector in the USA

Abstract

Emergency contraception, which prevents pregnancy after unprotected sexual intercourse, has the potential to significantly reduce the incidence of unintended pregnancy and the consequent need for abortion. The cost-effectiveness of emergency contraceptive pills in the public sector in the USA is determined. The cost-savings when a single emergency contraceptive treatment is provided following unprotected intercourse are modeled along with when women are provided emergency contraceptive pills in advance. This resulted in a saving of USD 1.94-4.47 for each dollar spent on a single treatment of emergency contraceptive pills depending on the emergency contraceptive pill regimen and assumptions about savings from costs avoided by preventing mistimed births. The dedicated products Preven and Plan B are cost-effective even under the least favorable assumption that mistimed births, when prevented today, occur 2 years later. Each dollar spent on advance provision of Preven saves from USD 2.06 to 20.05, and each dollar spent on Plan B saves from USD 1.51 to 9.30, depending on the regular ongoing method of contraception, how consistently emergency contraceptive pills are used when needed, and whether mistimed births are averted forever or simply delayed. Emergency contraception is cost-effective whether provided when the emergency arises or in advance to be used as needed. More extensive use of emergency contraception could save considerable medical and social costs by reducing unintended pregnancies, which are expensive.

Cost savings from use of emergency contraceptive pills in Australia

“…Emergency contraception reduces expenditures on medical care by preventing unintended pregnancies, which are expensive. Emergency contraceptive pills have been shown to be cost saving in the United States and in Canada 20–23 . Here we show that they are also cost‐saving in Australia.…”

Harm Reduction or Women's Rights? Debating Access to Emergency Contraceptive Pills in Canada and the United States

“…Recent research has challenged earlier analyses of the public health impact of emergency contraception. Whereas many studies pointed to the drug's potential to reduce rates of unintended pregnancy and the cost savings of preventing pregnancies (Trussell et al 1995(Trussell et al , 1997a(Trussell et al , and 1997bTrussell and Shochet 2003), these claims have been contested by recent studies that have shown no association between expanded access to emergency contraception and reduced rates of unintended pregnancy and induced abortion (see reviews by Raymond et al 2007 andPolis et al 2007). Some of these recent studies are now being cited by antichoice groups to argue against expanding access to emergency contraceptive pills.…”

Risk of pregnancy and external validity in clinical trials of emergency contraception

“…Consequently the cost effectiveness of EC in the general population may be overestimated as well. [16][17][18][19][20] Alternatively, non-enrolled women may be at higher risk of pregnancy than women in EC clinical trials because they are ineligible to enrol due to additional acts of UPSI in a cycle or because they decline to enrol, preferring a 'proven' EC regimen over an experimental regimen. In all randomised EC trials, as in our trial, enrolment is restricted to women who have only had one act of UPSI 72 (or 120) hours before they present at the clinic.…”