Background-LNG-IUS 13.5mg (total content) is a low-dose levonorgestrel intrauterine system for up to three years of use. This analysis evaluated the cost-effectiveness of LNG-IUS 13.5mg in comparison with short-acting reversible contraceptive (SARC) methods in a cohort of young women in the US from a third-party payer's perspective.Study Design-A state-transition model consisting of three mutually exclusive health statesinitial method, unintended pregnancy (UP) and subsequent method -was developed. Costeffectiveness of LNG-IUS 13.5mg was assessed versus SARC methods in a cohort of 1,000 women aged 20-29 years. SARC methods comprise oral contraceptives (OC), ring, patch and injections which are the methods commonly used by this cohort. Failure and discontinuation probabilities were based on published literature, contraceptive uptake was determined by the most recent data from the National Survey of Family Growth and costs were taken from standard US databases. One-way sensitivity analysis was conducted around key inputs while scenario analysis assessed a comparison between LNG-IUS 13.5mg and the existing IUS, LNG-IUS 20mcg/24 hours. The key model output was cost per UP avoided.Results-Compared to SARC methods, initiating contraception with LNG-IUS 13.5mg resulted in fewer UP (64 UP vs. 276 UP) and lower total costs ($1,283,479 USD vs. $1,862,633 USD, a 31% saving) over the three-year time horizon. Results were most sensitive to the probability of failure on OC, the probability of LNG-IUS 13.5mg discontinuation and the cost of live births. Scenario analysis suggests that further cost savings may be generated with the initiation of LNG-IUS 20mcg/24 hours in place of SARC methods.* Corresponding author. Amy Law, Bayer HealthCare Pharmaceuticals, Inc., Wayne, NJ 07470, USA, Tel: +1 (973) 487-5855; amy.law@bayer.com. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-From a third-party payer perspective, LNG-IUS 13.5mg is a more cost-effective contraceptive option than SARC. Therefore, women switching from current SARC use to LNG-IUS 13.5mg are likely to generate cost savings to third-party healthcare payers, driven principally by decreased UP-related expenditures and long-term savings in contraceptive costs.
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