ArticleAmerican journal of obstetrics and gynecology2018
Medicaid savings from the Contraceptive CHOICE Project: a cost-savings analysis.
Article in American journal of obstetrics and gynecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Same-day long-acting reversible contraceptive (LARC) placement: a systematic review of the benefits and barriers in the United States.BMC women's health · 2026Pooled it
- Use of hormonal intrauterine device and quarterly injection for contraception in adolescents with mental disorders.Journal of the Turkish German Gynecological Association · 2026Article
- The prevalence of contraceptive use among postpartum women and its associated factors during the early phase of COVID-19 outbreak: a time series study.Reproductive health · 2024Article
- An educational video on long-acting reversible contraception as a counseling tool for postpartum adolescents.Contraception and reproductive medicine · 2022Article
- Antiseizure medications and oral contraceptives: Impact of enzyme inducers on pregnancy outcomes and costs.Epilepsy & behavior : E&B · 2021Article
- Development of a pharmacoeconomic registry: an example using hormonal contraceptives.Health economics review · 2021Article
- Quantifying the economic burden of unintended pregnancies due to drug-drug interactions with hormonal contraceptives from the United States payer perspective.Gates open research · 2021Article
- Article
- Contraception for AdolescentsJournal of clinical research in pediatric endocrinology · 2020Article
- Contraceptive use and the intention to become pregnant among women attending the Brazilian Unified Health System.Revista latino-americana de enfermagem · 2020Article
- Long-acting reversible contraception: A route to reproductive justice or injustice.Infant mental health journal · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundForty-five percent of births in the United States are unintended, and the costs of unintended pregnancy and birth are substantial. Clinical and policy interventions that increase access to the most effective reversible contraceptive methods (intrauterine devices and contraceptive implants) have potential to generate significant cost savings. Evidence of cost savings for these interventions is needed.
objectiveThe purpose of this study was to conduct a cost-savings analysis of the Contraceptive CHOICE Project, which provided counseling and no-cost contraception, to demonstrate the value of investment in enhanced contraceptive care to the Missouri Medicaid program. STUDY
designThe Contraceptive CHOICE Project was a prospective cohort study of 9256 reproductive-age women who were enrolled between 2007 and 2011. Study follow-up was completed October 2013. This analysis includes 5061 Contraceptive CHOICE Project participants who were current Missouri Medicaid beneficiaries or were uninsured and reported household incomes <201% of the federal poverty line. We created a simulated comparison group of women who were receiving care through the Missouri Title X program and modeled the contraception and pregnancy outcomes that would have occurred in the absence of the Contraceptive CHOICE Project. Data about contraceptive use for the comparison group (N=5061) were obtained from the Missouri Title X program and adjusted based on age, race, ethnicity, and income. To make an accurate comparison that would account for the difference in the 2 populations, we used our simulation model to estimate total Contraceptive CHOICE Project costs and total comparison group costs. We reported all costs in 2013 dollars to account for inflation.
resultsAmong the Contraceptive CHOICE Project participants who were included, the uptake of intrauterine devices and implants was 76.1% compared with 4.8% among the comparison group. The estimated contraceptive cost for the simulated Contraceptive CHOICE Project group was $4.0 million vs $2.3 million for the comparison group. The estimated numbers of unintended pregnancies and births averted among the simulated Contraceptive CHOICE Project group compared with the comparison group were 927 and 483, respectively, which represented a savings in pregnancy and maternity care of $6.7 million. We estimated that the total cost savings for the state of Missouri attributable to the Contraceptive CHOICE Project was $5.0 million (40.7%) over the project duration.
conclusionA program providing counseling and no-cost contraception yields substantial cost savings because of the increased uptake of highly effective contraception and consequent averted unintended pregnancy and birth.
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