Cost–Utility Analysis of A Female Condom Promotion Program in Washington, DC


A retrospective economic evaluation of a female condom distribution and education program in Washington, DC. was conducted. Standard methods of cost, threshold and cost–utility analysis were utilized as recommended by the U.S. Panel on cost-effectiveness in health and medicine. The overall cost of the program that distributed 200,000 female condoms and provided educational services was $414,186 (at a total gross cost per condom used during sex of $3.19, including educational services). The number of HIV infections that would have to be averted in order for the program to be cost-saving was 1.13 in the societal perspective and 1.50 in the public sector payor perspective. The cost-effectiveness threshold of HIV infections to be averted was 0.46. Overall, mathematical modeling analyses estimated that the intervention averted approximately 23 HIV infections (even with the uncertainty inherent in this estimate, this value appears to well exceed the necessary thresholds), and the intervention resulted in a substantial net cost savings.

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Johns Hopkins University received support for this economic evaluation from the Female Health Company, the producer of the female condom product, FC2. The Washington DC Department of Health received support for the FC2 dissemination and education project from the Female Health Company; the educational project was also supported by the MAC AIDS Fund. Further details on this public/private sector partnership are provided in the text. Final control of the analysis and publication rested with the authors, not with any sponsor.

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Correspondence to David R. Holtgrave.

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Holtgrave, D.R., Maulsby, C., Kharfen, M. et al. Cost–Utility Analysis of A Female Condom Promotion Program in Washington, DC. AIDS Behav 16, 1115–1120 (2012).

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  • Female condom
  • HIV prevention
  • Economics
  • Cost-effectiveness analysis
  • Policy analysis