Oral Contraceptives are Cost-Effective when Used as Emergency Method

An analysis of the medical costs associated with the availability of emergency contraception (EC) in the US confirmed the cost-effectiveness of oral contraceptives (OCs)--but not the Copper T IUD--for this purpose. On the basis of published reports use of OCs for EC was estimated to result in a 74% reduction in the pregnancy rate compared with no treatment while IUD insertion for this purpose was assumed to reduce the risk of pregnancy by 99%. Two ways of delivering EC (during a routine visit for barrier contraception or after unprotected intercourse) in two provider settings (private managed care and publicly funded programs) were considered. The average total cost of outcomes of an unintended pregnancy was US$3795 under managed care and $1680 in a publicly funded program. Assuming that births averted by EC would never occur each use of combined pills resulted in savings of $142 under managed care and $54 in a public payer system. The IUD was cost-effective only if it remained in place for at least 4 months. If women receive an advance supply of EC pills from managed care providers and use the method whenever required the annual savings ranges from $263 for couples relying on male condoms to $498 for couples using the female condom. Even greater savings would occur if appropriate doses of combined OCs and minipills were packaged and labeled for this purpose.