OBJECTIVES: Unintended pregnancies have a negative social and economic impact on society. With the reporting decline in unintended pregnancy rates from 2008 to 2011 in the United States (US), we sought to evaluate the direct annual costs of unintended pregnancy in the US from a health care sector perspective.
METHODS: An economic model was developed to estimate direct annual medical costs of unintended pregnancy for all woman of reproductive age (15-44 years old) and per age group (15-19, 20-24, 25-29, 30-34, 35-44) not actively seeking pregnancy. The rates of unintended pregnancy and resulting pregnancy outcomes (live birth, termination, fetal loss, and ectopic pregnancy) were derived from published sources. For the base case analysis, the cost of each pregnancy outcome was conservatively based on publicly available 2018 Medicare reimbursement amounts. Additional analysis was performed to estimate cost of unintended pregnancy when accounting for insurance status/payer (private, public, uninsured) to reflect higher unit cost paid by private insurance.
RESULTS: Annual direct medical costs of unintended pregnancy in the United States were conservatively estimated to be at least $5.5 billion with 54.2% of costs ($3.0 billion) occurred in young women aged 20-29.
CONCLUSIONS: Despite declines in unintended pregnancy rates, the annual cost of unintended pregnancy in the US increased from a 2011 cost of $4.6 billion to $5.5 billion in 2018. The true economic burden is likely higher when factoring childcare and indirect costs.
