Should providers give women advance provision of emergency contraceptive pills? A cost-effectiveness analysis.

Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health
Diana Greene FosterPhilip Darney

Abstract

We sought to determine the potential effect and cost-effectiveness of different means of accessing emergency contraceptive pills (ECP) on unintended pregnancy rates in sexually active women. We used a computer simulation model to compare the effects of advance provision, on-demand provision, and no use of ECP on unintended pregnancies and costs of care in three hypothetical cohorts of 1 million sexually active women. Data on effectiveness of ECP from the single-use clinical trials, and costs from Medi-Cal, California's Medicaid program were used for the model. Advance provision of ECP is projected to avert a greater or the same percentage of unintended pregnancies compared with on-demand provision, with the greatest percentage of pregnancies averted (66%) in low-risk women with advance provision. In the simulation model, the percentage of pregnancies averted decreases as the frequency of unprotected intercourse increases and ECP use decreases. In all scenarios, the cost-savings ratio--the number of dollars saved on averted pregnancy expenditures for each dollar spent on advance ECP--is greater than one. Advance provision of ECP has the potential to avert unintended pregnancies and reduce medical expenditures. The most likely re...Continue Reading

References

Jul 2, 1998·The New England Journal of Medicine·A Glasier, D Baird
Jul 10, 2003·Obstetrics and Gynecology·Rebecca A JacksonPhilip Darney
Jan 15, 2004·Contraception·Elizabeth RaymondMarkus J Steiner
Nov 2, 2006·Obstetrics and Gynecology·Elizabeth G RaymondBarbara Van Der Pol
Nov 23, 2006·Lancet·James Trussell, Elizabeth G Raymond
Jan 2, 2007·Obstetrics and Gynecology·Elizabeth G RaymondChelsea B Polis
Dec 7, 2007·Obstetrics and Gynecology·Chelsea B PolisDavid A Grimes
Apr 22, 2008·The Cochrane Database of Systematic Reviews·L ChengP F A Van Look
May 20, 2008·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Diana G FosterClaire D Brindis
Nov 14, 2008·Journal of Health Services Research & Policy·Susan GriffinMark Sculpher

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Citations

Jul 5, 2012·Women's Health·Lydia E Pace, Eleanor Bimla Schwarz
Mar 20, 2013·Contraception·Diana Greene FosterEleanor Bimla Schwarz
May 12, 2012·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Tanya M PharesSusie Baldwin

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