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Objectives
Unintended pregnancies (UPs) in adolescents significantlyimpact young women, their
families/children, and society, however the full cost burden is currently not known.
The objectives were to quantify the direct cost of UPs in Canadian adolescents, the
proportion of UPs and cost attributable to imperfect contraceptive adherence, and
estimate the potential cost savings with increased uptake of long-acting reversible
contraceptives (LARCs) among adolescents.
Methods
A cost model was constructed to estimate the annual number and direct costs of UPs
in adolescent women aged 15-19years.Adherence-associated UP rates were estimated using
perfect- and typical-use failure rates. Change in annual number of UPs and impact
on cost burden were projected in three scenarios of increased LARC use. One-way sensitivity
analyses were conducted to assess impact of key variables on scenarios of increased
LARC use.
Results
Among Canadian adolescents, there are more than 39,000 UPs annually. The associated
direct cost was over $60 million; 61% of this cost ($37 million) was attributable
to contraceptive non-adherence. Increased LARC uptake produced cost savings of over
$3million in all three switching scenarios; the largest savings ($3.6 million) occurred
when 10% of females using either a SARC or no method switched to LARCs. Minimum duration
of LARC usage required before realizing cost savings was 6.8 months.
Conclusions
The cost of UPs in Canadian adolescents is significant and largely attributed to imperfect
contraceptive adherence. Increased LARC uptake in adolescents may improve ongoing
contraceptive adherence, thereby reducing rates of adolescent UP and generating significant
cost savings in this age group.
Key Words
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Copyright
© 2019 Published by Elsevier Inc.
