Cost‐effectiveness analysis of a low‐dose contraceptive levonorgestrel intrauterine system in Sweden. (17th June 2015)

• Record Type: Journal Article
• Authors: Henry, Nathaniel; Hawes, Charlie; Lowin, Julia; Lekander, Ingrid; Filonenko, Anna; Kallner, Helena K.
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 94:Number 8(2015)
• Page Start: 884
• Page End: 890
• Publication Date: 2015-06-17
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12679
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12679-abs-0001"> <title>Abstract</title> <sec id="aogs12679-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate the cost‐effectiveness of a novel intrauterine system, levonorgestrel intrauterine system 13.5 mg vs. oral contraception, in women at risk of unintended pregnancy.</p> </sec> <sec id="aogs12679-sec-0002" sec-type="section"> <title>Design</title> <p>Cost‐effectiveness model using efficacy and discontinuation data from published articles.</p> </sec> <sec id="aogs12679-sec-0003" sec-type="section"> <title>Setting</title> <p>Societal perspective including direct and indirect costs.</p> </sec> <sec id="aogs12679-sec-0004" sec-type="section"> <title>Population</title> <p>Women at risk of unintended pregnancy using reversible contraception.</p> </sec> <sec id="aogs12679-sec-0005" sec-type="section"> <title>Methods</title> <p>An economic analysis was conducted by modeling the different health states of women using contraception over a 3‐year period. Typical use efficacy rates from published articles were used to determine unintended pregnancy events. Discontinuation rates were used to account for method switching.</p> </sec> <sec id="aogs12679-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Cost‐effectiveness was evaluated in terms of the incremental cost per unintended pregnancy avoided. In addition, the incremental cost per quality‐adjusted life‐year was calculated.</p> </sec> <sec id="aogs12679-sec-0007" sec-type="section"> <title>Results</title> <p>Levonorgestrel intrauterine system 13.5 mg generated costs savings of €311 000 in a cohort of 1000 women aged 15–44 years. In addition, there were fewer unintended pregnancies (55 vs. 294) compared with women using oral contraception.</p> </sec> <sec id="aogs12679-sec-0008" sec-type="section"> <title>Conclusion</title> <p>Levonorgestrel intrauterine system 13.5 mg is a cost‐effective method when compared with oral contraception. A shift in contraceptive use from oral contraception to long‐acting reversible contraception methods could result in fewer unintended pregnancies, quality‐adjusted life‐year gains, as well as cost savings.</p> </sec> </abstract>