Economic evaluation of Zika Contraception Access Network in Puerto Rico during the 2016–17 Zika virus outbreak

Details

• Alternative Title:
  Contraception
• Personal Author:
  Li, Rui ; Ellington, Sascha R. ; Galang, Romeo R. ; Grosse, Scott D. ; Mendoza, Zipatly ; Hurst, Stacey ; Vale, Yari ; Lathrop, Eva ; Romero, Lisa
• Description:
  Objective:
  
  During the 2016-2017 Zika virus (ZIKV) outbreak, the prevention of unintended pregnancies was identified as a primary strategy to prevent birth defects. This study estimated the cost-effectiveness of the Zika Contraception Access Network (Z-CAN), an emergency response intervention that provided women in Puerto Rico with access to the full range of reversible contraception at no cost and compared results with a preimplementation hypothetical cost-effectiveness analysis (CEA).
  
  Study Design:
  
  We evaluated costs and outcomes of Z-CAN from a health sector perspective compared to no intervention using a decision tree model. Number of people served, contraception methods mix, and costs under Z-CAN were from actual program data and other input parameters were from the literature. Health outcome measures included the number of Zika-associated microcephaly (ZAM) cases and unintended pregnancies. The economic benefits of the Z-CAN intervention were ZIKV-associated direct costs avoided, including lifetime medical and supportive costs associated with ZAM cases, costs of monitoring ZIKV-exposed pregnancies and infants born from Zika-virus infected mothers, and the costs of unintended pregnancies prevented during the outbreak as a result of increased contraception use through the Z-CAN intervention.
  
  Results:
  
  The Z-CAN intervention cost a total of $26.1 million, including costs for the full range of reversible contraceptive methods, contraception related services, and programmatic activities. The program is estimated to have prevented 85% of cases of estimated ZAM cases and unintended pregnancies in the absence of Z-CAN. The intervention cost was projected to have been more than offset by $79.9 million in ZIKV—associated costs avoided, 96% of which were lifetime ZAM-associated costs, as well as $137.0 million from avoided unintended pregnancies, with total net savings in one year of $216.9 million. The results were consistent with the previous CEA study.
  
  Conclusion:
  
  Z-CAN was likely cost-saving in the context of a public health emergency response setting.
  
  
• Subjects:
  Article Contraception Cost-effectiveness Outbreak Unintended Pregnancy Zika Virus
• Source:
  Contraception. 107:68-73
• Pubmed ID:
  34748752
• Pubmed Central ID:
  PMC8897811
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  Puerto Rico
• Volume:
  107
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8c84313af3c6ffeebbf4b4494646b2eda4dff4641c99359a221d95efd9d5e82c
• Download URL:
  https://stacks.cdc.gov/view/cdc/115094/cdc_115094_DS1.pdf
• File Type:
  [PDF - 253.26 KB ]