Providing increased access to contraception to women in Puerto Rico during the Zika outbreak would be a cost-saving measure, including avoiding $62.3 million in costs related to Zika-linked microcephaly, researchers from the US Centers for Disease Control and Prevention (CDC) and Puerto Rico reported today.
In other Zika developments, the Florida Department of Health (Florida Health) has reported three more locally acquired cases in the past 2 days, all involving residents of Miami-Dade County.
Contraception costs and benefits
The group based its projection on a public health intervention that would include a hypothetical $33.5 million in family planning services—considered a key to preventing Zika-related birth defects—to help women who want to delay or avoid pregnancy. The researchers published their findings today in an early online edition of Emerging Infectious Diseases.
Puerto Rican women have multiple barriers to contraceptive use, including high cost, shortage of supplies, lack of information about options, and a limited number of family planning sites, the investigators said. The team estimates that 65% of pregnancies are unintended in Puerto Rico, compared with 45% on the US mainland.
The CDC and local partners are hoping to improve access to contraception in Puerto Rico, including a wider range of options, including long-acting reversible methods.
The group based its cost-effectiveness calculations on a target population of 163,000 sexually active women who want to avoid pregnancy, with the increased contraception intervention in place during a year-long Zika outbreak in Puerto Rico. The researchers also assumed that some women would want to switch to a more effective contraception method.
Using the cost of treating cytomegalovirus-related microcephaly as a proxy, they estimated that medical and nonmedical care for a baby born with Zika-linked microcephaly would total $3.8 million, a number that could rise to as much as $10 million if the child survives to adulthood.
Increased access to birth control might have the potential to reduce Zika-related costs by $65.2 million: $2.8 million from less Zika testing and $62.3 million in money saved by avoiding Zika-linked microcephaly. They also said the program would save $40.4 million in unrelated Zika costs by cutting the number of unintended pregnancies.
"Zika virus can cause devastating birth defects, and infants born with ZAM [Zika virus-associated microcephaly] and their families will require lifelong support," the group wrote. "Avoiding unintended pregnancies is a critical intervention to mitigate the effects of ZAM. Efforts to prevent adverse Zika virus–related pregnancy outcomes in Puerto Rico are especially important because of limited resources."
Florida developments
In updates yesterday and today, Florida Health reported three more locally acquired cases, all in Miami-Dade County. Investigators are still trying to determine where the three people were exposed to the virus. The new illnesses bring the state's local case total to 185.
Over the last 2 days that state also reported nine more travel-related cases, as well as four more infections in pregnant women. The infected travelers are from Collier, Miami-Dade, Orange, and St. Lucie counties. Florida's travel-linked Zika total now stands at 773, and officials are monitoring 127 infections in pregnant women.
See also:
Nov 1 Emerg Infect Dis report
Oct 31 Florida Health daily Zika update
Nov 1 Florida Health daily Zika update
