期刊
CONTRACEPTION
卷 107, 期 -, 页码 68-73出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.contraception.2021.10.009
关键词
Contraception; Cost-effectiveness; Outbreak; Unintended pregnancy; Zika virus
资金
- National Foundation for the Centers for Disease Control and Prevention, Inc. (CDC Foundation)
- Bill & Melinda Gates Foundation
- Bloomberg Philanthropies
- William and Flora Hewlett Foundation
- The Pfizer Foundation
- American College of Obstetricians and Gynecologists
This study evaluated the cost-effectiveness of the Zika Contraception Access Network (Z-CAN) and found that it was likely cost-saving in the context of a public health emergency response setting.
Objective: During the 2016-2017 Zika virus (ZIKV) outbreak, the prevention of unintended pregnancies was identified as a primary strategy to prevent birth defects. This study estimated the cost-effectiveness of the Zika Contraception Access Network (Z-CAN), an emergency response intervention that provided women in Puerto Rico with access to the full range of reversible contraception at no cost and compared results with a preimplementation hypothetical cost-effectiveness analysis (CEA). Study Design: We evaluated costs and outcomes of Z-CAN from a health sector perspective compared to no intervention using a decision tree model. Number of people served, contraception methods mix, and costs under Z-CAN were from actual program data and other input parameters were from the literature. Health outcome measures included the number of Zika-associated microcephaly (ZAM) cases and unintended pregnancies. The economic benefits of the Z-CAN intervention were ZIKV-associated direct costs avoided, including lifetime medical and supportive costs associated with ZAM cases, costs of monitoring ZIKV-exposed pregnancies and infants born from Zika-virus infected mothers, and the costs of unintended pregnancies prevented during the outbreak as a result of increased contraception use through the Z-CAN intervention. Results: The Z-CAN intervention cost a total of $26.1 million, including costs for the full range of reversible contraceptive methods, contraception related services, and programmatic activities. The program is estimated to have prevented 85% of cases of estimated ZAM cases and unintended pregnancies in the absence of Z-CAN. The intervention cost was projected to have been more than offset by $79.9 million in ZIKV-associated costs avoided, 96% of which were lifetime ZAM-associated costs, as well as $137.0 million from avoided unintended pregnancies, with total net savings in one year of $216.9 million. The results were consistent with the previous CEA study. Conclusion: Z-CAN was likely cost-saving in the context of a public health emergency response setting. Published by Elsevier Inc.
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