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AJPH First Look, published online ahead of print Aug 13, 2008
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99/3/446    most recent
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March 2009, Vol 99, No. 3 | American Journal of Public Health 446-451
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.129353

RESEARCH AND PRACTICE

Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

Diana Greene Foster, PhD, Daria P. Rostovtseva, MS, Claire D. Brindis, DrPH, M. Antonia Biggs, PhD, Denis Hulett, BA and Philip D. Darney, MD

All authors are with the Bixby Center for Global Reproductive Health, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Diana Greene Foster, PhD, 1330 Broadway, Suite 1100, Oakland, CA 94612 (e-mail: greened{at}obgyn.ucsf.edu).

Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program.

Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies.

Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43.

Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods.






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