Erratum to “Cost effectiveness of contraceptives in the United States” [Contraception 79 (2009) 5–14]

Objective The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians’ recommendation of the copper IUD for emergency contraception in a setting with few cost obstacles. Methods We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. Results The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. While over 93% of obstetrician–gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Conclusion Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method.

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“…The method becomes cost-effective in a year, and by 5 years of use is the most cost-effective contraceptive available. 28 …”

Section: Discussionmentioning

confidence: 99%

Copper Intrauterine Device for Emergency Contraception

Harper

Speidel

Drey

et al. 2012

Obstetrics & Gynecology

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“…40 Health care professionals should provide all patients with comprehensive, scientifically accurate information about the full range of available contraceptive options. 41 The decision to initiate, continue or discontinue any contraceptive method belongs to the patient and should be honored.…”

Section: Recommendations and Conclusionmentioning

confidence: 99%

Increasing Access to Intrauterine Devices and Contraceptive Implants

2023

Obstetrics &Amp; Gynecology

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Everyone who desires long-acting reversible contraception should have timely access to contraceptive implants and intrauterine devices. Obstetrician-gynecologists and other reproductive health care clinicians can best serve those who want to delay or avoid pregnancy by adopting evidence-based practices and offering all medically appropriate contraceptive methods. Long-acting reversible contraceptive devices should be easily accessible to all people who want them, including adolescents and those who are nulliparous and after spontaneous or induced abortion and childbirth. To achieve equitable access, the American College of Obstetricians and Gynecologists supports the removal of financial barriers to contraception by advocating for coverage and appropriate payment and reimbursement for all contraceptive methods by all payers for all eligible patients.

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Three Strategies to Prevent Unintended Pregnancy

Thomas¹

2012

J Policy Anal Manage

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This paper presents results from fiscal impact simulations of three national-level policies designed to prevent unintended pregnancy: A media campaign encouraging condom use, a pregnancy prevention program for at-risk youth, and an expansion in Medicaid family planning services. These simulations were performed using Fam-ilyScape, a recently developed agent-based simulation model of family formation. In some simulation specifications, policies' benefits are monetized by accounting for projected reductions in government expenditures on medical care for pregnant women and infants. In a majority of these specifications, policies' fiscal benefit-cost ratios are less than 1. However, in specifications that account additionally for projected savings to programs that provide a broader range of benefits and services to young children, all three policies have benefit-cost ratios that are comfortably greater than 1. The results from my preferred specifications suggest that the simulated policies would produce returns to taxpayers on each dollar spent of between $2 to $6. On the whole, the results of these simulations imply that all three policies are sound public investments. C 2012 by the Association for Public Policy Analysis and Management.1 On the share of pregnancies that are unintended, see Finer and Zolna (in press). 2 Information on the marriage rates of women who experience intended and unintended pregnancies is taken from unpublished tabulations of data gathered by the Guttmacher Institute. For a survey of

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Erratum to “Cost effectiveness of contraceptives in the United States” [Contraception 79 (2009) 5–14]

Cited by 7 publications

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Copper Intrauterine Device for Emergency Contraception

Copper Intrauterine Device for Emergency Contraception

Increasing Access to Intrauterine Devices and Contraceptive Implants

Three Strategies to Prevent Unintended Pregnancy

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