title: Cost-effectiveness analysis of a low-dose contraceptive levonorgestrel intrauterine system in Sweden.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Cost-effectiveness model using efficacy and discontinuation data from published articles.
  
  
  METHODS
  Societal perspective including direct and indirect costs.
  
  
  METHODS
  Women at risk of unintended pregnancy using reversible contraception.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: IMS Health, London, UK.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Henry
authors.affiliation: IMS Health, London, UK.
authors.forename: Charlie
authors.initials: C
authors.lastname: Hawes
authors.affiliation: IMS Health, London, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Lowin
authors.affiliation: Bayer AB, Solna, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Lekander
authors.affiliation: Bayer Pharma AG, Berlin, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Filonenko
authors.affiliation: Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
authors.forename: Helena K
authors.initials: HK
authors.lastname: Kallner
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003276:Contraceptives, Oral / Q000191:economics*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000191:economics*; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000191:economics*; D018803:Models, Economic; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D013548:Sweden; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D016912:Levonorgestrel
keywords: Long-acting reversible contraception; abortion; cost-effectiveness analysis; levonorgestrel intrauterine system; unintended pregnancy; unwanted pregnancy