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Achieving cost-neutrality with long-acting reversible contraceptive methods.

James Trussell1, Fareen Hassan2, Julia Lowin2

  • 1Office of Population Research, Princeton University, Princeton, NJ 08540, USA.

Contraception
|October 6, 2014
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Summary

Long-acting reversible contraceptive (LARC) methods, including IUDs and implants, become more cost-effective than short-acting reversible contraceptive (SARC) methods within three years. This analysis considers discontinuation rates for accurate cost-saving estimations.

Keywords:
Cost savingsCost studyLARCSARCUnintended pregnancy

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Area of Science:

  • Reproductive Health Economics
  • Contraceptive Technology Assessment

Background:

  • Long-acting reversible contraceptive (LARC) methods are often promoted for their cost-effectiveness over extended use.
  • Previous economic analyses may not have fully accounted for discontinuation rates, potentially overestimating LARC cost-savings.

Purpose of the Study:

  • To estimate the average annual costs of reversible contraceptive methods in the United States.
  • To determine the minimum duration of LARC use required for cost-neutrality compared to short-acting reversible contraceptive (SARC) methods, considering discontinuation.

Main Methods:

  • A three-state economic model was developed to compare costs over a 5-year horizon for 1000 women aged 20-29.
  • Methods included no method, four SARCs (oral contraceptive, ring, patch, injection), and three LARCs (implant, copper IUD, LNG-IUS).
  • Costs analyzed included acquisition, administration, and unintended pregnancy due to method failure.

Main Results:

  • The copper IUD ($304/year) and LNG-IUS ($308/year) were the least expensive methods.
  • SARC method costs ranged from $432/year (injection) to $730/year (patch).
  • LARC methods achieve cost-savings compared to SARCs after a minimum of 2.1 years of use.

Conclusions:

  • LARC methods demonstrate cost-savings relative to SARC methods within 3 years of use, even when accounting for discontinuation.
  • These findings provide a more realistic economic argument for LARC adoption by considering real-world usage patterns.