Cost Effectiveness of Contraceptives in the United States

James Trussell, Princeton University
Anjana Lalla, Cerner Corporation
Quan Doan, Cerner Corporation
Eileen Reyes, Cerner Corporation
Lionel Pinto, Cerner Corporation
Joseph Gricar, Independent Consultant

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 IUD ($647), vasectomy ($713) and LNG-20 IUS ($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.