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Cost-benefit analysis of immediate postabortal IUD insertion
Abortion, Contraception
Awarded 2011
Complex Family Planning Fellowship Research
Jennifer Salcedo, MD, MPH, MPP
University of California, Los Angeles

Background: Immediate postabortal intrauterine device (IUD) insertion decreases rates of repeat abortions. However, only one third of high-volume, non-hospital abortion providers in the United States offer immediate postabortal IUD placement.
Study Design: We conducted a cost analysis from a public payer perspective to evaluate the potential cost savings associated with a policy of immediate postabortal IUD insertion, compared to planned IUD insertion at the time of abortion follow up. Sensitivity analyses and Monte Carlo simulation were performed.
Results: Considering only direct costs of contraception and pregnancy-related care over one year, immediate postabortal IUD provision decreases public program expenditures by US$111 per woman compared to planned IUD placement at follow up. Over 5 years, the savings increases to $4296 per woman, when public health and social program costs are also considered.
Conclusion: Immediate postabortal IUD insertion is cost saving from a public payer perspective, compared to planned insertion at the time of follow up. These savings are seen over a wide range of model inputs.