Document Detail


Should providers give women advance provision of emergency contraceptive pills? A cost-effectiveness analysis.
MedLine Citation:
PMID:  20620913     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Diana G Foster; Tina R Raine; Claire Brindis; Daria P Rostovtseva; Philip D Darney
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2010-07-12     Completed Date:  2011-02-03     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  9101000     Medline TA:  Womens Health Issues     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-7     Citation Subset:  IM    
Copyright Information:
2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
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:
K24 HD057086/HD/NICHD NIH HHS; K24 HD057086-02/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Contraceptives, Postcoital
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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