Cost of unintended pregnancy in Sweden - a possibility to lower costs by increasing LARC usage

Abstract

Objectives: The objective of this study was to determine the cost of unintended pregnancy (UP) in Sweden and savings generated by a switch of 5% of women from short-acting reversible contraception (SARC) and other methods to long-acting reversible contraceptives (LARCs).

Study design: We constructed an economic model to estimate the number and costs of UPs and contraceptive use over a 1-year period. The population consisted of all women aged 15-44years requiring reversible contraception and at risk of UP. UPs could result in birth, spontaneous abortion, induced abortion, and ectopic pregnancy. The model included costs incurred by the healthcare payer or out-of-pocket expenses by women, and indirect costs, i.e., foregone wages from time away from work.

Results: We estimated 73,989 unintended pregnancies yearly, amounting to costs of almost €158 million. A 5% switch from non-LARCs to LARCs would generate more than 3500 fewer UPs yearly with savings of nearly €7.7 million. The majority of these savings would arise from reduced costs for UPs.

Conclusions: UPs are costly for society and women. A small change in the proportion of women using the most effective methods generates substantial cost savings due to fewer UPs and thus fewer abortions. A switch in 5% of women using non-LARCs could prevent more than 3500 UPs yearly, generating savings of more than SEK 70 million (€7.7 million) or of 2.4% of costs for UPs.

Keywords: Abortion; Contraception; Cost-effectiveness; LARC; Termination of pregnancy; Unintended pregnancy.