Real-world cost-effectiveness of etonogestrel implants compared to long-term and short term reversible contraceptive methods in France.
Adolescent
Adult
Contraception
Contraceptive Agents, Female
Contraceptives, Oral
/ economics
Cost-Benefit Analysis
Desogestrel
/ administration & dosage
Drug Administration Routes
Female
France
Humans
Levonorgestrel
/ administration & dosage
Long-Acting Reversible Contraception
/ economics
Middle Aged
Models, Economic
Pregnancy
Young Adult
Contraceptive methods
abortion
contraceptive failure
cost-effectiveness
etonogestrel implant
long-acting reversible contraceptives
Journal
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception
ISSN: 1473-0782
Titre abrégé: Eur J Contracept Reprod Health Care
Pays: England
ID NLM: 9712127
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
pubmed:
8
5
2021
medline:
28
10
2021
entrez:
7
5
2021
Statut:
ppublish
Résumé
To estimate the cost-effectiveness (CE) of etonogestrel implants compared to other long-term and short-term reversible contraceptive methods available in France. A 6-year Markov model compared effectiveness between the implant and six other contraceptive methods in sexually active, not-pregnancy-seeking French females of reproductive age. Contraception efficacy, switch rates and outcomes were based on French current medical practice. Incremental CE ratios (ICERs) were calculated as incremental cost per unintended pregnancy (UP) avoided. Efficiency frontier was plotted to identify cost-effective methods. Uncertainty was explored through sensitivity analyses. The implant was on the efficiency frontier along with combined oral contraceptive pill (COC) and copper IUD. Implant avoids between 0.75% and 3.53% additional UP per person-year compared to copper IUD and second generation COC, respectively, with an ICER of €2,221 per UP avoided compared to copper IUD. For the 240,000 French women currently using the implant, up to 8,475 UPs and up to 1,992 abortions may be prevented annually. With more unintended pregnancies avoided and comparable costs to copper IUD, the implant is a cost-effective option among long-term and short-term reversible contraceptive methods.
Sections du résumé
BACKGROUND
BACKGROUND
To estimate the cost-effectiveness (CE) of etonogestrel implants compared to other long-term and short-term reversible contraceptive methods available in France.
RESEARCH DESIGN AND METHODS
METHODS
A 6-year Markov model compared effectiveness between the implant and six other contraceptive methods in sexually active, not-pregnancy-seeking French females of reproductive age. Contraception efficacy, switch rates and outcomes were based on French current medical practice. Incremental CE ratios (ICERs) were calculated as incremental cost per unintended pregnancy (UP) avoided. Efficiency frontier was plotted to identify cost-effective methods. Uncertainty was explored through sensitivity analyses.
RESULTS
RESULTS
The implant was on the efficiency frontier along with combined oral contraceptive pill (COC) and copper IUD. Implant avoids between 0.75% and 3.53% additional UP per person-year compared to copper IUD and second generation COC, respectively, with an ICER of €2,221 per UP avoided compared to copper IUD. For the 240,000 French women currently using the implant, up to 8,475 UPs and up to 1,992 abortions may be prevented annually.
CONCLUSION
CONCLUSIONS
With more unintended pregnancies avoided and comparable costs to copper IUD, the implant is a cost-effective option among long-term and short-term reversible contraceptive methods.
Identifiants
pubmed: 33960248
doi: 10.1080/13625187.2021.1900562
doi:
Substances chimiques
Contraceptive Agents, Female
0
Contraceptives, Oral
0
etonogestrel
304GTH6RNH
Levonorgestrel
5W7SIA7YZW
Desogestrel
81K9V7M3A3
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM