Presentation (CTI)

OBJECTIVES: Abnormal Uterine Bleeding (AUB) significantly impacts women's health and quality of life. Hysterectomy and the 52 mg levonorgestrel intrauterine system (52 mg LNG-IUS) are potential interventions to improve outcomes. This study compares the costs of these interventions for AUB from the Brazilian public healthcare perspective.
METHODS: Data on hysterectomies performed in 2024 were obtained from DATASUS, the Brazilian public health database. Costs for both interventions were extracted from the literature and DATASUS to estimate their economic impact. Analyses included national data and cities with the highest hysterectomy numbers in each region of the country. The average waiting time for hysterectomy in the public system was also evaluated through the Brazilian Freedom of Information Law. An exchange rate of USD 1 = BRL 5.40 was applied.
RESULTS: The first-year cost per patient was estimated at USD 223 for the 52 mg LNG-IUS and USD 522 for hysterectomy. In 2023, hysterectomies for AUB cost Brazil approximately USD 47.1 million. Switching to the 52 mg LNG-IUS, even considering that 24% might still require surgery, could save USD 15.7 million. In capitals with the highest hysterectomy numbers, savings would be: USD 400,529 (São Paulo), USD 329,470 (Salvador), USD 232,799 (Maceio), USD 190,043 (São Luis), and USD 180,460 (Aracaju). The average waiting time for hysterectomy was 59 days.
CONCLUSIONS: The 52 mg LNG-IUS is a cost-saving alternative to hysterectomy in Brazil’s public healthcare system. Its adoption could reduce surgical demand, shorten waiting times, and improve care access. By lowering costs and enhancing women’s quality of life, this alternative addresses both economic and clinical challenges in managing AUB.