| Should providers give women advance provision of emergency contraceptive pills? A cost-effectiveness analysis. | |
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MedLine Citation:
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PMID: 20620913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: 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. METHODS: 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. FINDINGS: 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. CONCLUSION: Advance provision of ECP has the potential to avert unintended pregnancies and reduce medical expenditures. The most likely reason that the advance provision trials fail to demonstrate reductions in pregnancy rates is a result of a combination of small study sizes, the use of ECP in both treatment and control groups, and a failure to take into account a realistic range of rates of unprotected intercourse and imperfect ECP use. |
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Authors:
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Diana G Foster; Tina R Raine; Claire Brindis; Daria P Rostovtseva; Philip D Darney |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Women's health issues : official publication of the Jacobs Institute of Women's Health Volume: 20 ISSN: 1878-4321 ISO Abbreviation: Womens Health Issues Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-07-12 Completed Date: 2011-02-03 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 9101000 Medline TA: Womens Health Issues Country: United States |
Other Details:
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Languages: eng Pagination: 242-7 Citation Subset: IM |
Copyright Information:
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2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Bixby Center for Reproductive Health Research & Policy, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA. greened@obgyn.ucsf.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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California Computer Simulation Contraceptives, Postcoital / economics* Cost-Benefit Analysis Female Health Services Accessibility / economics* Humans Pregnancy Pregnancy, Unplanned* Sexual Behavior |
| Grant Support | |
ID/Acronym/Agency:
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K24 HD057086-02/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Contraceptives, Postcoital |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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