Abstract:
OBJECTIVE:To examine from the health care services payer perspective the economic consequences of contraceptives available to women in the United States. METHODS:A Markov model was constructed to compare effectiveness and costs among nine contraceptive methods (including 3-month injectable, oral contraceptives, intrauterine device (IUD), intrauterine system (IUS), barrier methods and surgical methods). Primary health states included initial/continued use, method failure and method discontinuation with transitions every year for 5 years. Plan disenrollment was also incorporated in the model. Estimates for probabilities of events, resource used, and costs for the base-case were derived from a comprehensive literature review, average wholesale drug prices, the 2000 Medicare Reimbursement Fee Schedule and MEDSTAT's 2000 DRG Guide, in conjunction with expert opinion. Sensitivity analyses were performed on all variables. RESULTS:Aside from vasectomy, which was outside the scope of this study, the most effective methods were tubal ligation, levonorgestrel (LNG)-20 IUS and copper T 380A IUD. The least expensive methods (accounting for all costs) were LNG-20 IUS, copper T 380A IUD and 3-month injectable; the 5-year cost/person were $1646, $1678 and $2195, respectively. CONCLUSION:From a third-party payer perspective, LNG-20 IUS and copper T 380A IUD dominated all reviewed methods, except for tubal ligation. However, the small increase in contraceptive efficacy with tubal ligation has a high cost. IUD and IUS device costs have a significant impact on the relative cost-effectiveness of these two methods.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Chiou CF,Trussell J,Reyes E,Knight K,Wallace J,Udani J,Oda K,Borenstein Jdoi
10.1016/s0010-7824(03)00078-7subject
Has Abstractpub_date
2003-07-01 00:00:00pages
3-10issue
1eissn
0010-7824issn
1879-0518pii
S0010782403000787journal_volume
68pub_type
杂志文章相关文献
CONTRACEPTION文献大全abstract::Information relating to the effect of steroids on the metabolism and motility of human spermatozoa is limited despite the increasing interest in the use of these hormones for the purpose of contraception. In the present study it was shown that progesterone, testosterone, and 11-beta-OH-progesterone significantly inhib...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(81)90080-9
更新日期:1981-05-01 00:00:00
abstract::A drug delivery system which provides a sustained release of norethindrone (NET) and mestranol (ME) for one month after a single intramuscular injection was assessed as a long-acting injectable contraceptive. The system is based upon well defined particle size crystals of the synthetic steroids maintained in suspensio...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(87)90051-5
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To assess the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health-worker-administered intramuscular DMPA (DMPA-IM) in Uganda. STUDY DESIGN:We developed a decision-tree model with a 12-month time horizon for a hypothetical cohort of approximately 1 m...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2018.07.137
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Between 2006 and 2008, Iowa increased access to family planning services through a Medicaid expansion and a privately funded initiative. During this same time, Iowa expanded access to abortion through telemedicine provision of medical abortion. Despite increased access to abortion services, abortions in Iowa...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2014.10.009
更新日期:2015-02-01 00:00:00
abstract::A 1-year longitudinal multicenter study was undertaken to monitor the effects on lipid metabolism of two once-a-month injectable contraceptive preparations, Mesigyna (50 mg norethisterone enanthate and 5 mg estradiol valerate and Cyclofem (25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate). A total of 357...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:In levonorgestrel intrauterine system (LNG-IUS) users, the prevention of sperm penetration through cervical mucus has not been demonstrated. STUDY DESIGN:Subjects were enrolled in an investigator-blinded study to compare quality and sperm penetrability of mid-cycle cervical mucus between LNG-IUS users and h...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/j.contraception.2010.06.006
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Obesity is becoming increasingly common in obstetric and gynecologic populations, which may affect the safety of surgical termination of pregnancy. STUDY DESIGN:We performed a retrospective review of all patients undergoing second-trimester surgical termination of pregnancy by under ultrasound guidance term...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2012.02.006
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Hormonal contraception is the most common medication used by reproductive aged women but there is little understanding of the impact of hormonal contraception on obesity and metabolism. Adipokine levels (adiponectin, resistin) and markers of adipocyte development (DLK-1) are altered in obese animals and huma...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2012.10.029
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To develop and validate standardized criteria for assessing abortion-related incidents (adverse events, morbidities, near misses) for first-trimester aspiration abortion procedures and to demonstrate the utility of a standardized framework [the Procedural Abortion Incident Reporting & Surveillance (PAIRS) Fr...
journal_title:Contraception
pub_type: 杂志文章,评审
doi:10.1016/j.contraception.2017.05.004
更新日期:2017-07-01 00:00:00
abstract::The aim of this study was to characterize the bleeding pattern, the outcome of pregnancies and the levonorgestrel plasma levels associated with method failures in Norplant implants users. Nineteen pregnancies are reported in 458 woman and 21,589 woman-months observed during the first eight years of Norplant use. Pregn...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(86)90096-x
更新日期:1986-04-01 00:00:00
abstract::There is a global need for an ideal method of male contraception. However, the development of male contraceptives has not been well successful. Research on sperm-specific ion channels, especially the recent advance obtained from electrophysiological studies, has emphasized the conception that those channels are target...
journal_title:Contraception
pub_type: 杂志文章,评审
doi:10.1016/j.contraception.2013.06.002
更新日期:2013-10-01 00:00:00
abstract::In a cross-over study with orally administered desogestrel (0.150 mg) plus ethinyloestradiol (0.030 mg) and 3-keto-desogestrel (0.150 mg) plus ethinyloestradiol (0.030 mg) in ten women under steady-state conditions, the serum levels of 3-keto-desogestrel were monitored by radioimmunoassay. No statistically significant...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(86)90047-8
更新日期:1986-06-01 00:00:00
abstract::The presence of medical conditions that might affect the use of depot-medroxyprogesterone acetate (DMPA) as a contraceptive method was assessed in a rural district in Nepal. A general health survey was conducted in nonpregnant and noncontracepting women aged 15-44 years to determine the presence of any health problems...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(99)00056-6
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:Female sterilization is one of the most prevalent methods of contraception in the United States. Prior studies have shown that nearly half of postpartum tubal ligation (PPTL) requests go unfulfilled. This study seeks to establish whether obstetric or medical risk status influences patients' request for or sub...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2016.08.009
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To determine the acceptability of taking mifepristone at home for early medical abortion in the United States. STUDY DESIGN:This prospective, non-randomized, open-label study at six Planned Parenthood centers gave women with pregnancies up to 63 days' gestation seeking medical abortion the choice of taking m...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.contraception.2015.06.026
更新日期:2015-09-01 00:00:00
abstract::Subcutaneously administered implant-D containing 40 mg of Norethindrone acetate in a single silastic implant was offered to 79 subjects who desired spacing of their family. The effect of constant release of steroid from this device on metabolic and endocrine functions was studied. Each subject in the pretreatment stat...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(79)80026-8
更新日期:1979-02-01 00:00:00
abstract::The objective of the study was to assess the efficacy of cervical preparation with misoprostol or laminaria suction abortion up to 18 weeks gestation. The study was conducted among a consecutive case series of patients presenting for dilatation and evacuation at a single center. Cervical preparation was effected by ei...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/s0010-7824(02)00306-2
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVES:The objectives were to assess acceptors' attitudes toward Sayana® Press as a method and toward the mechanism of community-based distribution by medical and nursing (M/N) students, known locally as "DBCs," in Kinshasa, Democratic Republic of the Congo, and to evaluate the experience of these DBCs. STUDY DESI...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2017.05.014
更新日期:2017-09-01 00:00:00
abstract::This open-label, nonrandomized study compared changes in hemostatic variables during NuvaRing and oral levonorgestrel 150 microg/ethinylestradiol 30 microg (LNG/EE) use for six cycles. Eighty-seven women started the study, 44 with NuvaRing and 43 with the LNG/EE oral contraceptive. For most procoagulation variables, t...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/j.contraception.2003.12.010
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To explore perspectives on family planning among young people who perceive they are infertile or will have difficulty carrying a pregnancy to term owing to medical conditions or procedures. METHODS:This exploratory analysis examined pregnancy plans and contraceptive behavior among 12 young adults with a diag...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2019.03.046
更新日期:2019-07-01 00:00:00
abstract::This prospective, open-label, randomized trial of healthy adult women up to 9 weeks pregnant compared mifepristone 200 mg followed 2 days later with misoprostol 400 microg orally versus misoprostol 800 microg vaginally. The study was interrupted after the oral misoprostol group experienced a higher than expected failu...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0010-7824(02)00366-9
更新日期:2002-10-01 00:00:00
abstract::A report that serum prolactin concentrations were almost doubled by the use of copper IUDs led us to study the effect of both copper and inert IUDs. We studied 105 normal women in whom all other prolactinergic factors had been excluded; 25 of them were using copper IUDs, 25 were using inert IUDs and there were 55 cont...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(79)90049-0
更新日期:1979-11-01 00:00:00
abstract::Phospholipases A2 and C (93 and 500 mU) were administered to uterine horns of Long-Evans adult rats during the first five days of pregnancy. As control material, saline (0.15 M) was administered to contralateral uterine horns. The animals were sacrificed on the ninth day of pregnancy, the uterine horns were removed an...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(82)90023-3
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:The objective was to investigate changes in luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2) and progesterone (P) during the hormone-free interval (HFI) of 6 combined oral contraceptives (COCs). DESIGN:Blood samples were obtained from 62 women. RESULTS:When COCs were grouped by e...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/j.contraception.2014.01.021
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:In response to concerns about serious infections following medical abortion, in early 2006 the Planned Parenthood Federation of America changed the route of misoprostol administration from vaginal to buccal and required either routine antibiotic coverage or universal screening and treatment for chlamydia; in...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2010.08.022
更新日期:2011-04-01 00:00:00
abstract::There is agreement that the relative risk of developing pelvic inflammatory disease (PID) increases among women who use the intrauterine contraceptive device (IUD). The role of Chlamydia in causing PID among IUD users is not clear. The present study demonstrates that Chlamydia trachomatis growth can be inhibited in cu...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/0010-7824(89)90041-3
更新日期:1989-06-01 00:00:00
abstract::This investigation describes the synthesis of a biodegradable hydrogel composed of a core surrounded by four concentric sheaths containing dextran, copolymers of polylactide and epsilon-caprolactone. The hydrogel was impregnated with iron (II) d-gluconate dihydrate, which causes complete spermiostasis due to lipid per...
journal_title:Contraception
pub_type: 杂志文章
doi:10.1016/j.contraception.2004.02.015
更新日期:2004-09-01 00:00:00
abstract::The objectives of the study were to assess the ability of the Femcap, a new vaginal contraceptive device made of silicone and designed to fit snugly around the cervix to prevent the penetration of sperm into midcycle cervical mucus when used with and without spermicide; and to compare it with the standard contraceptiv...
journal_title:Contraception
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0010-7824(97)00098-x
更新日期:1997-08-01 00:00:00
abstract::To determine the safety of transcervical administration of quinacrine pellets as a method of voluntary female sterilization, three noncomparative Phase I clinical trials of the administration of 250 mg quinacrine were carried out in 21 women who were scheduled to undergo hysterectomy 24 h or one month later. Detailed ...
journal_title:Contraception
pub_type: 临床试验,杂志文章
doi:10.1016/s0010-7824(96)00174-6
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Although widely used, the mechanisms of action of the levonorgestrel emergency contraceptive pill (LNG ECP) are still unclear. There are increasing data to indicate that LNG is particularly effective as an ECP by interrupting follicular development and ovulation. An important outstanding question is whether ...
journal_title:Contraception
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.contraception.2006.08.015
更新日期:2007-02-01 00:00:00