CostBenefit Analysis on Health Effects of Contraceptive Methods

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Cost-Benefit Analysis on Health Effects of
Contraceptive Methods

• Elizabeth ONeill, ECON 539, 4.25.07

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• 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.

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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.
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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). QALYs 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.
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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

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Summary of Results
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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).

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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?