Cost Effectiveness of Contraceptives in the United States

Overview

Journal Contraception

Publisher Elsevier

Specialty Reproductive Medicine

Date 2008 Dec 2

PMID 19041435

Citations 88

Authors

James Trussell

Anjana M Lalla

Quan V Doan

Eileen Reyes

Lionel Pinto

Joseph Gricar

Affiliations

Soon will be listed here.

Abstract

Background: The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer's perspective.

Methods: A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates.

Results: Any contraceptive method is superior to "no method". The three least expensive methods were the copper-T intrauterine device (IUD) (US$647), vasectomy (US$713) and levonorgestrel (LNG)-20 intrauterine system (IUS) (US$930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy and plan disenrollment rates.

Conclusion: The copper-T IUD, vasectomy and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy and time horizon are influential factors that determine the overall value of a contraceptive method.

Citing Articles

Comparing vasectomy techniques, recovery and complications: tips and tricks.

Borrell J, Gu C, Ye N, Mills J, Andino J Int J Impot Res. 2025; .

PMID: 39890927 DOI: 10.1038/s41443-025-01018-5.

Effects of structured contraceptive counseling in young women: Secondary analyses of a cluster randomized controlled trial (the LOWE trial).

Iwarsson K, Podolskyi V, Bizjak I, Kopp Kallner H, Gemzell-Danielsson K, Envall N Acta Obstet Gynecol Scand. 2024; 103(11):2242-2251.

PMID: 39327830 PMC: 11505211. DOI: 10.1111/aogs.14954.

First, a seat; then, an upgrade.

Sathyanarayanan A J Hum Hypertens. 2024; 38(8):620-623.

PMID: 38987380 DOI: 10.1038/s41371-024-00933-2.

Providing a post-vasectomy semen analysis cup at the time of vasectomy rather than post-operatively improves compliance.

Zhu E, Saba B, Bernstein A, Hernandez H, Rapoport E, Najari B Transl Androl Urol. 2024; 13(1):72-79.

PMID: 38404558 PMC: 10891388. DOI: 10.21037/tau-23-400.

Advances in contraception: vaginal contraceptive rings.

Al-Haddad S, Branham K, Clare C Ther Adv Reprod Health. 2023; 17:26334941231186733.

PMID: 37465002 PMC: 10350750. DOI: 10.1177/26334941231186733.

References

Backman T, Huhtala S, Blom T, Luoto R, Rauramo I, Koskenvuo M . Length of use and symptoms associated with premature removal of the levonorgestrel intrauterine system: a nation-wide study of 17,360 users. BJOG. 2000; 107(3):335-9. DOI: 10.1111/j.1471-0528.2000.tb13228.x. View

Trussell J, LeVEQUE J, Koenig J, London R, Borden S, Henneberry J . The economic value of contraception: a comparison of 15 methods. Am J Public Health. 1995; 85(4):494-503. PMC: 1615115. DOI: 10.2105/ajph.85.4.494. View

Hooton T, Scholes D, Hughes J, Winter C, Roberts P, Stapleton A . A prospective study of risk factors for symptomatic urinary tract infection in young women. N Engl J Med. 1996; 335(7):468-74. DOI: 10.1056/NEJM199608153350703. View

Jick S, Kaye J, Russmann S, Jick H . Risk of nonfatal venous thromboembolism in women using a contraceptive transdermal patch and oral contraceptives containing norgestimate and 35 microg of ethinyl estradiol. Contraception. 2006; 73(3):223-8. DOI: 10.1016/j.contraception.2006.01.001. View

Peterson H, Xia Z, Hughes J, Wilcox L, Tylor L, Trussell J . The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med. 1997; 336(11):762-7. DOI: 10.1056/NEJM199703133361104. View

Fihn S, Latham R, Roberts P, Running K, Stamm W . Association between diaphragm use and urinary tract infection. JAMA. 1985; 254(2):240-5. View

Audet M, Moreau M, Koltun W, Waldbaum A, Shangold G, Fisher A . Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial. JAMA. 2001; 285(18):2347-54. DOI: 10.1001/jama.285.18.2347. View

Vaughan B, Trussell J, Kost K, Singh S, Jones R . Discontinuation and resumption of contraceptive use: results from the 2002 National Survey of Family Growth. Contraception. 2008; 78(4):271-83. PMC: 2800035. DOI: 10.1016/j.contraception.2008.05.007. View

Marquette C, Koonin L, Antarsh L, Gargiullo P, Smith J . Vasectomy in the United States, 1991. Am J Public Health. 1995; 85(5):644-9. PMC: 1615419. DOI: 10.2105/ajph.85.5.644. View

10.

Mosher W, Martinez G, Chandra A, Abma J, Willson S . Use of contraception and use of family planning services in the United States: 1982-2002. Adv Data. 2005; (350):1-36. View

11.

Strauss L, Gamble S, Parker W, Cook D, Zane S, Hamdan S . Abortion surveillance--United States, 2003. MMWR Surveill Summ. 2006; 55(11):1-32. View

12.

Chiou C, Trussell J, Reyes E, Knight K, Wallace J, Udani J . Economic analysis of contraceptives for women. Contraception. 2003; 68(1):3-10. DOI: 10.1016/s0010-7824(03)00078-7. View

13.

MacKay A, Kieke Jr B, Koonin L, Beattie K . Tubal sterilization in the United States, 1994-1996. Fam Plann Perspect. 2001; 33(4):161-5. View

14.

Trussell J, Vaughan B . Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth. Fam Plann Perspect. 1999; 31(2):64-72, 93. View

15.

Backman T, Rauramo I, Huhtala S, Koskenvuo M . Pregnancy during the use of levonorgestrel intrauterine system. Am J Obstet Gynecol. 2004; 190(1):50-4. DOI: 10.1016/j.ajog.2003.07.021. View

16.

Baldaszti E, Wimmer-Puchinger B, Loschke K . Acceptability of the long-term contraceptive levonorgestrel-releasing intrauterine system (Mirena): a 3-year follow-up study. Contraception. 2003; 67(2):87-91. DOI: 10.1016/s0010-7824(02)00482-1. View

17.

Trussell J, Koenig J, Stewart F, Darroch J . Medical care cost savings from adolescent contraceptive use. Fam Plann Perspect. 1998; 29(6):248-55, 295. View

18.

Phillips C . Economic analysis of long-term reversible contraceptives. Focus on Implanon. Pharmacoeconomics. 2000; 17(2):209-21. DOI: 10.2165/00019053-200017020-00009. View

19.

Trussell J, Koenig J, Ellertson C, Stewart F . Preventing unintended pregnancy: the cost-effectiveness of three methods of emergency contraception. Am J Public Health. 1997; 87(6):932-7. PMC: 1380926. DOI: 10.2105/ajph.87.6.932. View

20.

Trussell J . Overstating the cost savings from contraceptive use. Eur J Contracept Reprod Health Care. 2008; 13(3):219-21. DOI: 10.1080/13625180802359263. View