Cost-effectiveness analysis of 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS) versus short-acting hormonal contraceptives in avoiding unintended pregnancy (UP) in 15 to 19 year-old adolescents under the Brazilian Public Healthcare System

Abstract

Objective: The aim of this study was to evaluate the cost- effectiveness of levonorgestrel-releasing intrauterine system (LNG-IUS) Mirena® in avoiding unintended pregnancy in 15 to 19 year-old adolescents compared to short-term hormonal contraceptives under the Brazilian Public Healthcare System (SUS) perspective. Methods: For economic evaluation, a Markov model was developed, with one year cycles, to follow the adolescents along the natural course of contraceptives use, under a time horizon of five years. Clinical data were obtained from the literature review. Unit costs were extracted from official databases. Only direct medical costs were included. Costs and benefits were discounted at a rate of 5% per year. Outcomes were expressed as unplanned pregnancy avoided. Results: The cost-effectiveness results showed that LNG-IUS is able to bring savings with gain in effectiveness when compared to the most common methods used by adolescents (oral and injectable contraceptives). Sensitivity analyses confirmed the results found in the base case. Conclusion: Considering the satisfactory clinical and economic results, LNG-IUS should be considered as an important option for avoiding unplanned pregnancy in adolescence, along with all its consequences.