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Objective <p>Unintended pregnancy among adolescent is a worldwide problem. In this study, a decision-tree model was constructed to analyze the cost and effectiveness of different contraceptive methods for Chinese adolescents in preventing unintended pregnancy.</p> Methods <p>From a healthcare system perspective, this study evaluated the cost and effectiveness of combined oral contraceptive (COC), copper intrauterine device (Cu-IUD), levonorgestrel intrauterine system (LNG-IUS) and subdermal implant contraceptive methods used by 14.88 million women aged 15–24 years with contraceptive needs within 5 years in 2023. The cost parameters were derived from the China Medical Information Platform and medical institutions or literature. Effectiveness was defined as pregnancies, abortions, and births averted. The clinical parameters were derived from the WHO and published literature. Cost-effectiveness analysis was used to determine whether contraceptive measures are economically favorable. Univariate sensitivity analysis and probabilistic sensitivity analysis were conducted to verify the robustness of the model.</p> Results <p>The cost of Cu-IUD was the lowest, and it costed RMB 369.67 per unintended pregnancy averted among adolescents. The subdermal implant had the highest number of unintended pregnancies. Compared with COC, Cu-IUD had significant contraceptive advantages and achieved better clinical outcomes at a lower cost. LNG-IUS and subdermal implant were also cost-effectiveness when compared with COC, with ICER of 7556.78 and 12,271.85, both of which were lower than the gross domestic product per capita of China.</p> Conclusions <p>Long-acting reversible contraceptive(LARC) methods are more cost-effective than COC. Given rising adolescent contraceptive needs and high unintended pregnancy rates, healthcare providers should recommend LARC and ensure timely counseling and services to protect adolescent reproductive health.</p>

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Cost-effectiveness of four contraceptive methods to avoid unintended pregnancy among adolescents in China: an analysis based on decision-tree model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月25日

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  • Weihua Luo,
  • Di Wang,
  • Zeyuan Zhang,
  • Yanyan Wang,
  • Ruifeng Li,
  • Gan Xu,
  • Liangru Zhou

摘要

Objective

Unintended pregnancy among adolescent is a worldwide problem. In this study, a decision-tree model was constructed to analyze the cost and effectiveness of different contraceptive methods for Chinese adolescents in preventing unintended pregnancy.

Methods

From a healthcare system perspective, this study evaluated the cost and effectiveness of combined oral contraceptive (COC), copper intrauterine device (Cu-IUD), levonorgestrel intrauterine system (LNG-IUS) and subdermal implant contraceptive methods used by 14.88 million women aged 15–24 years with contraceptive needs within 5 years in 2023. The cost parameters were derived from the China Medical Information Platform and medical institutions or literature. Effectiveness was defined as pregnancies, abortions, and births averted. The clinical parameters were derived from the WHO and published literature. Cost-effectiveness analysis was used to determine whether contraceptive measures are economically favorable. Univariate sensitivity analysis and probabilistic sensitivity analysis were conducted to verify the robustness of the model.

Results

The cost of Cu-IUD was the lowest, and it costed RMB 369.67 per unintended pregnancy averted among adolescents. The subdermal implant had the highest number of unintended pregnancies. Compared with COC, Cu-IUD had significant contraceptive advantages and achieved better clinical outcomes at a lower cost. LNG-IUS and subdermal implant were also cost-effectiveness when compared with COC, with ICER of 7556.78 and 12,271.85, both of which were lower than the gross domestic product per capita of China.

Conclusions

Long-acting reversible contraceptive(LARC) methods are more cost-effective than COC. Given rising adolescent contraceptive needs and high unintended pregnancy rates, healthcare providers should recommend LARC and ensure timely counseling and services to protect adolescent reproductive health.