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Cost-Benefit Analysis on Health Effects of Contraceptive Methods

Cost-Benefit Analysis on Health Effects of Contraceptive Methods. Elizabeth O’Neill, ECON 539, 4.25.07. Central Questions : What are the net health effects and subsequent costs resulting from using various methods of contraception as compared to not using contraception?

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Cost-Benefit Analysis on Health Effects of Contraceptive Methods

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  1. Cost-Benefit Analysis on Health Effects of Contraceptive Methods Elizabeth O’Neill, ECON 539, 4.25.07

  2. Central Questions: • What are the net health effects and subsequent costs resulting from using various methods of contraception as compared to not using contraception? • What are the policy recommendations based on the results? Reference: Sonnenberg, R., Burkman, R., Hagerty, G., Speroff, L., Speroff, T. (2004) Costs and Net Health Effects of Contraceptive Methods. Contraception. 69: 447-459.

  3. Methods Data source: 1995 National Survey of Family Growth monitoring a 2 yr. period. Sample: Women 15-50 y.o. who are not attempting to become pregnant during the duration of the study. Causal statement: Thirteen methods of contraception affect various health factors including cancer, cardiovascular, infections and pregnancy but are more effective and less costly than not using a contraceptive.

  4. Units of Analysis Costs were a total $ amount (not disaggregated by private, public or insured costs). Contraceptive methods were expressed in terms of saved quality-adjusted life-years(QALYs). QALY’s are calculated by multiplying each increment of survival by the utility of the increment. Model assumes women will use same method(s) continuously = benefits & cost savings overestimated in the report.

  5. Cost-Benefit Analysis Factors • Cost (US $) • Marginal cost (US $) • Quality-adjusted life-years • Marginal quality-adjusted life-years • Cost savings vs. number of methods • Pregnancies avoided per woman vs. # of methods • QALY gains vs. # methods

  6. Summary of Results

  7. Detailed Cost-Utility Results • Least expensive method varies for different time periods: • Within 1 year: DMPA (3-month injectable) is the least costly ($5,103 savings) • Within 2+ years: Vasectomy is the least costly ($17,300 saved over a 5-year period) • Any contraceptive method used provided substantial healthcare savings and an increase in QALYs. • Methods that require “user intervention less often than daily are the least costly and most effective” (Sonnenberg et al, 2004).

  8. Policy Implications • Managed care organizations/health plans should consider providing some contraceptive services as a cost saving measure. • Promote DMPA for short-term pregnancy prevention and vasectomies for longer-term prevention through physician and patient education. • Further studies needed to determine public/private payment effects on the findings. • Questions?

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