The purpose of this study was to examine implications of increased perfect use on the cost- effectiveness of the contraceptive patch compared with combination oral contraceptives (COCs). This study compared the patch with low- estrogen- dose COCs. It assumes that the risks of developing a medical condition during use are the same for both the patch and COCs. Differences in net cost and pregnancies avoided during use were modeled. With the use of a pharmacoeconomic model, both methods were compared with a hypothetical reference case of contraception nonuse. The base- case model considered women, ages 15 to 50, in average health in a long- term, mutually monogamous, heterosexual relationship. The base- case analysis showed that use of the patch resulted in a savings of ＄ 249 and 0.03 pregnancies per woman over 2 years compared with COCs. This analysis demonstrated that patch use would be cost saving compared with COC use, resulting in a net avoidance of pregnancy for this population. The cost savings are attributed to reduced costs of pregnancy. The purpose of this study was to examine implications of increased perfect use on the cost- effectiveness of the contraceptive patch compared with combination oral contraceptives (COCs). This study compared the patch with low- estrogen- dose COCs. It assumes that the risks of developing a medical condition during use are the same for both the patch and COCs. With the use of a pharmacoeconomic model, both methods were compared with a hypothetical reference case of contraception nonuse. base-case model considered women, ages 15 to 50, in average health in a long- term, mutually monogamous, heterosexual relationship. The base-case analysis showed that use the the patch resulted in a savings of $ 249 and 0.03 pregnancies per woman over 2 years compared with COCs. This analysis demonstrates that patch use would be cost saving compared with COC use, resulting in a net avoidance of pregnancy for this population. T he cost savings are attributed to reduced costs of pregnancy.