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Abstract
Emergency contraception, which prevents pregnancy after unprotected sexual intercourse, has the potential to significantly reduce the incidence of unintended pregnancy and the consequent need for abortion. The cost-effectiveness of emergency contraceptive pills in the public sector in the USA is determined. The cost–savings when a single emergency contraceptive treatment is provided following unprotected intercourse are modeled along with when women are provided emergency contraceptive pills in advance. This resulted in a saving of US$1.94–4.47 for each dollar spent on a single treatment of emergency contraceptive pills depending on the emergency contraceptive pill regimen and assumptions about savings from costs avoided by preventing mistimed births. The dedicated products Preven and Plan B are cost-effective even under the least favorable assumption that mistimed births, when prevented today, occur 2 years later. Each dollar spent on advance provision of Preven saves from US$2.06 to 20.05, and each dollar spent on Plan B saves from US$1.51 to 9.30, depending on the regular ongoing method of contraception, how consistently emergency contraceptive pills are used when needed, and whether mistimed births are averted forever or simply delayed. Emergency contraception is cost-effective whether provided when the emergency arises or in advance to be used as needed. More extensive use of emergency contraception could save considerable medical and social costs by reducing unintended pregnancies, which are expensive.