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The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France

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  • Ramona Schmid

Abstract

Objective: To evaluate the cost-effectiveness of ulipristal acetate and levonorgestrel in minors in France, and analyze whether it is worthwhile to provide ulipristal acetate to minors free of charge. Methods: The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model. Pregnancy rates, outcomes of unintended pregnancies, and resource utilization were derived from the literature. Resources and their costs were considered until termination or a few days after delivery. Deterministic and probabilistic sensitivity analyses were performed. Results: The cost of an unintended pregnancy in a French minor is estimated to be 1,630 € (range 1,330 € – 1,803 €). Almost 4 million € (3.1 € – 13.7 € million) in unintended pregnancy spending in 2010 could have been saved by the use of ulipristal acetate instead of levonorgestrel. The incremental cost of ulipristal acetate compared to levonorgestrel is 3.30 € per intake, or 418 € per pregnancy avoided (intake within 72 hours). In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel. Conclusions: Ulipristal acetate dominates levonorgestrel when taken within 24 hours after unprotected intercourse, i.e., it is more effective at a lower cost. When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies. In the light of these findings, it is worthwhile to provide free access to minors.

Suggested Citation

  • Ramona Schmid, 2015. "The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-15, September.
    • Handle: RePEc:plo:pone00:0138990
    DOI: 10.1371/journal.pone.0138990
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    References listed on IDEAS

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    1. Daniel Klepinger & Shelly Lundberg & Robert Plotnick, 1999. "How Does Adolescent Fertility Affect the Human Capital and Wages of Young Women?," Journal of Human Resources, University of Wisconsin Press, vol. 34(3), pages 421-448.
    2. Trussell, J. & Koenig, J. & Ellertson, C. & Stewart, F., 1997. "Preventing unintended pregnancy: The cost-effectiveness of three methods of emergency contraception," American Journal of Public Health, American Public Health Association, vol. 87(6), pages 932-937.
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