Cost effectiveness of contraceptives in the United States

Contraception. 2009 Jan;79(1):5-14. doi: 10.1016/j.contraception.2008.08.003. Epub 2008 Sep 25.


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 intrauterine device (IUD) (US$647), vasectomy (US$713) and levonorgestrel (LNG)-20 intrauterine system (IUS) (US$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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contraceptive Agents / economics*
  • Cost-Benefit Analysis*
  • Female
  • Health Care Costs*
  • Humans
  • Intrauterine Devices, Copper / economics*
  • Levonorgestrel / economics*
  • Markov Chains
  • Pregnancy
  • Pregnancy, Unplanned
  • United States
  • Vasectomy / economics*


  • Contraceptive Agents
  • Levonorgestrel