OBJECTIVES: Long-acting reversable contraceptives (LARC; implants, intrauterine systems, and intrauterine devices) are very effective reversible methods requiring little user adherence. We sought to evaluate the impact of increased utilization of LARC in young 20-29 years old women on UPs and costs from a US health care sector perspective.
METHODS: An economic model was developed to estimate the impact increased utilization of LARC would have on an annual cost and UPs. The model included 20-29 years old women that were not seeking pregnancy. The rates of UPs, resulting pregnancy outcomes (live birth, termination, fetal loss, and ectopic pregnancy), contraception utilization and failure rates were derived from published sources. The UP cost accounted for insurance status/payer (private, public, uninsured). Contraceptive costs were based on wholesale acquisition costs; the LARC costs were annualized to reflect the longer duration of use. We modeled several switching scenarios of increased LARC utilization including switching women currently using oral contraceptive, switching women currently using any short-acting reversible contraceptive (SARC), and switching women currently using any SARC or no method. Women switched to either a LARC market basket, to the least expensive LARC, or to the least expensive intrauterine system.
RESULTS: Given a 5% switch to LARC, potential annual cost savings ranged from $104.7 million to $333.4 million for the analyzed switch scenarios. A reduction in the estimated number of unintended pregnancies ranged from 14,431 to 69,213 for the analyzed scenarios.
CONCLUSIONS: Increased use of LARCs among women 20-29 years old could potentially reduce the burden of untended pregnancies in the US and reduce cost. Availability of more LARC options could facilitate higher LARC utilization thus further increasing possible savings.
