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Abstract #153927

Diana Greene Foster, PhD¹, Claire Brindis, DrPH², M. Antonia Biggs, PhD¹, Gorette Amaral, MHS¹, Heike Thiel de Bocanegra, PhD, MPH³, Daria P. Rostovtseva, MS⁴, and Phillip Darney, MD, MSc⁴. (1) Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, 50 Beale Street, 12th floor, San Francisco, CA 94501, (415) 509-5964, greened@obgyn.ucsf.edu, (2) Philip R. Lee Institute for Health Policy Studies, UCSF, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143, (3) University of California, San Francisco, Bixby Center for Reproductive Health, Research & Policy, University of California, San Francisco, CDPH Office of Family Planning, P.O. Box 997413, MS 8400, Sacramento, CA 95899-7413, (4) Bixby Center for Reproductive Health Research & Policy, University of California, San Francisco, CDHS Office of Family Planning, P.O. Box 997413, MS 8400, Sacramento, CA 95899-7413

Introduction: Although research has shown substantial savings in public expenditures from subsidizing family planning services to low-income women, there is little information on the relative cost-effectiveness of specific contraceptive methods. The literature shows the theoretical cost effectiveness of different methods of contraception, not taking into account the likelihood of method discontinuation. In this study we examine cost savings from specific methods of contraception by assessing the cost of visits and pregnancies that may occur by method type.

Methods: We compare the costs of providing contraceptives through the large California State Family PACT program to the costs of unintended pregnancy to public programs using contraceptive method dispensing data for 955,000 women in 2003. We estimate the number of pregnancies averted through use of specific contraceptive methods to be the difference between Family PACT client pregnancies and the number of pregnancies expected in the absence of that method given the previous method dispensed.

Results: Among short-term methods, the injectable contraceptives have the highest savings at $5.46 saved per dollar in services, followed by oral contraceptives ($4.28), the patch ($3.12), and the ring ($2.56). Barrier methods and emergency contraception have lower savings at approximately $1.50 per dollar spent on services. Expenditures on services for adolescents yield approximately twice the savings as services for adults.

Discussion: Expenditures on all contraceptive methods have a positive return in preventing unintended pregnancy. Policy makers may use these findings for justifying coverage of all contraceptive methods. Potential contraceptive users may use the findings to assist in method selection.

Learning Objectives:

• 1. Understand the factors affecting the potential of a contraceptive method to avert unintended pregnancy including method continuation, effectiveness and months of contraceptive coverage dispensed.
• 2. Describe how to estimate pregnancies averted in the presence and absence of a family planning program.
• 3. Identify the costs associated with providing a contraceptive method and the costs associated with an unintended pregnancy.
• 4. Discuss the relative cost effectiveness of specific methods of contraception and its implications for client education and insurance coverage of contraceptive methods.

Keywords: Contraceptives, Economic Analysis

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.