Cost-Effectiveness of PPIUD Initiative

Outcome of interestaBangladeshTanzania
Estimated NumberICER Without Cost OffsetbICER With Cost OffsetEstimated NumberICER Without Cost OffsetbICER With Cost Offsetc
PPIUDs inserted8,03167.2PPIUD dominates7,448251.169.9
CYPs36,94314.6PPIUD dominates34,26154.615.2
Unintended pregnancies averted16,68332.3PPIUD dominates15,471120.833.7
Maternal deaths averted1150,731.0PPIUD dominates3062,316.917,358.8
Child deaths averted638,613.0PPIUD dominates3066,109.51,701.8
Total DALYs averted (maternal + child DALYs)5,91891.1PPIUD dominates27,62667.718.9
  • Abbreviations: CYP, couple-years of protection; DALYs, disability-adjusted life years; ICER, incremental cost-effectiveness ratio; PPIUD, postpartum intrauterine device.

  • a Outcomes are the estimated service lifespan impacts from the Impact 2 tool.

  • b The ICER without cost offset is equivalent to the cost per outcome because the cost of standard practice is estimated as zero cost in both study groups without any impact on the ICER.

  • c When neither the intervention nor standard care “dominates,” the ICER should be used to decide whether or not to invest (see Figure 2).