Cost‐effectiveness analysis of a low‐dose contraceptive levonorgestrel intrauterine system in Sweden

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. DESIGN: Cost‐effectiveness model using efficacy and discontinuation data from published articles. SETTING: Societal perspective including direct and indirect costs. POPULATION: 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. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.