Office of Population Research, Princeton University, Princeton, NJ 08540, USA.
Contraception. 2013 Feb;87(2):154-61. doi: 10.1016/j.contraception.2012.07.016. Epub 2012 Sep 7.
This study evaluated the total costs of unintended pregnancy (UP) in the United States (US) from a third-party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure.
An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all women requiring reversible contraception in the US: the pattern of contraceptive use and the rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated.
Annual medical costs of UP in the United States were estimated to be $4.6 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 20-29 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year.
Imperfect contraceptive adherence leads to substantial UP and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence.
本研究从第三方医疗支付者的角度评估了美国非意愿妊娠（UP）的总成本，并探讨了长效可逆避孕（LARC）在降低 UP 和由此产生的医疗支出方面的潜在作用。
构建了一个经济模型来估计 UP 的直接成本，以及可归因于避孕不依从的 UP 成本比例。该模型考虑了美国所有需要可逆避孕的女性：避孕使用模式和 UP 发生率均源自已发表的资料。估计了美国 UP 的成本以及通过增加 LARC 的使用提高避孕依从性可能避免的总成本比例。
美国 UP 的年度医疗费用估计为 46 亿美元，其中 53%归因于避孕不依从。如果 20-29 岁的女性中有 10%将口服避孕药更换为 LARC，每年的总成本将减少 2.88 亿美元。
避孕不依从导致 UP 和高昂、可避免的成本。通过减少避孕不依从，提高 LARC 的使用率可能会节省医疗保健成本。
