To make decisions about switching from iron folic acid (IFA) to multiple micronutrient supplementation (MMS), policymakers must consider not only the health benefits of such a policy change, but also the costs. To help guide the decisions, the objective of this analysis was to estimate the effectiveness and cost‐effectiveness of hypothetically replacing IFA supplements with MMS for 1 year in the context of an ongoing program to deliver supplements to pregnant women in Bangladesh and Burkina Faso.