Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

Emerg Infect Dis. 2017 Jan;23(1):74-82. doi: 10.3201/eid2301.161322. Epub 2017 Jan 15.


We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus-related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus-associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs.

Keywords: Puerto Rico; Zika virus; contraception; cost-effectiveness; cost-saving; microcephaly; outbreak; unintended pregnancy; vector-borne infections; viruses.

MeSH terms

  • Adult
  • Contraception / economics*
  • Contraception / methods
  • Cost-Benefit Analysis*
  • Decision Trees
  • Disease Outbreaks*
  • Female
  • Forecasting
  • Health Care Costs
  • Humans
  • Microcephaly / economics
  • Microcephaly / epidemiology
  • Microcephaly / prevention & control*
  • Microcephaly / virology
  • Population Surveillance
  • Pregnancy
  • Pregnancy Complications, Infectious / economics
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / prevention & control*
  • Pregnancy Complications, Infectious / virology
  • Puerto Rico / epidemiology
  • Zika Virus / pathogenicity
  • Zika Virus / physiology
  • Zika Virus Infection / economics
  • Zika Virus Infection / epidemiology
  • Zika Virus Infection / prevention & control*
  • Zika Virus Infection / virology