MANAGEMENT BASED ON THE INSTITUTIONALIZATION OF HEALTH TECHNOLOGY ASSESSMENT (HTA): THE CASE OF THE ETONOGESTREL SUBDERMAL IMPLANT IN A BRAZILIAN PRIVATE HEALTH INSURANCE
Author(s)
Sérgio Rachkorsky, MD1, Francisco Prota, MA, MD2, Fernanda Trevisan Maldonado, MD1, Tassia Ginciene, MBA3, Ricardo Bueno, BA, MHA, PhD4, Yohanna Ramires, MSc5, Tiago José de Almeida Silva, MD3.
1Unimed Sorocaba, Sorocaba, Sorocaba, Brazil, 2Unimed Campinas, Campinas, Brazil, 3Organon Brazil, São Paulo, Brazil, 4Graduate Program in Corporate Governance (MP-FMU), São Paulo, Brazil; Public Policy Program of School of Public Administration (DDPP-ENAP), São Paulo, Brazil, 5Organon, Fazenda Rio Grande, Brazil.
1Unimed Sorocaba, Sorocaba, Sorocaba, Brazil, 2Unimed Campinas, Campinas, Brazil, 3Organon Brazil, São Paulo, Brazil, 4Graduate Program in Corporate Governance (MP-FMU), São Paulo, Brazil; Public Policy Program of School of Public Administration (DDPP-ENAP), São Paulo, Brazil, 5Organon, Fazenda Rio Grande, Brazil.
OBJECTIVES: To evaluate the economic impact of the etonogestrel contraceptive implant (ESI) through a real-world analysis from the perspective of a Brazilian health plan.
METHODS: A retrospective cross-sectional study was conducted to assess the costs and utilization related to the use of long-acting reversible contraceptives (LARCs), using data derived from a secondary database of health insurance. A historical database, with volume of hormonal intrauterine device (hIUD) and implant, was developed, stratified by insertion site (hospital or outpatient) and procedure-related costs. Data were categorized and analyzed using descriptive statistics, with categorical variables reported as frequencies and percentages, and continuous variables with non-normal distribution reported as medians and interquartile ranges (IQRs). Comparisons between means were performed using the t-test, while medians were compared using the Mann-Whitney test.
RESULTS: A historical database covering a three-year period (2022-2024), was analyzed, with the incorporation occurring in the 4th quarter of 2022. A total of 10,066 IUD insertion were recorded, corresponding to R$ 17,939,524.00, of which 3,058 (30.4%) were performed in a hospital. After incorporation, 321 implants were used, totalizing R$ 382,339.89, which represents an average increase of 0.5% in the use of LARCs and of portfolio growth of 2.6%. Compared to IUD insertion procedures performed in outpatient and hospital settings, the implant was associated with costs 18.1% and 53.0% lower, respectively, in relation to the average ticket value dispensed. Considering the distribution of insertion sites, the availability of the implant resulted in savings of R$ 170,853.93 and contributed to a 23.4% reduction in IUD-h insertions in a hospital setting.
CONCLUSIONS: The ESI proved to be an effective health management tool, optimizing resource allocation by generating significant cost savings in contraception. The assertive application of HTA (Health Technology Assessment) supported the efficient management of resources and contributed to the sustainability of the complementary health system.
METHODS: A retrospective cross-sectional study was conducted to assess the costs and utilization related to the use of long-acting reversible contraceptives (LARCs), using data derived from a secondary database of health insurance. A historical database, with volume of hormonal intrauterine device (hIUD) and implant, was developed, stratified by insertion site (hospital or outpatient) and procedure-related costs. Data were categorized and analyzed using descriptive statistics, with categorical variables reported as frequencies and percentages, and continuous variables with non-normal distribution reported as medians and interquartile ranges (IQRs). Comparisons between means were performed using the t-test, while medians were compared using the Mann-Whitney test.
RESULTS: A historical database covering a three-year period (2022-2024), was analyzed, with the incorporation occurring in the 4th quarter of 2022. A total of 10,066 IUD insertion were recorded, corresponding to R$ 17,939,524.00, of which 3,058 (30.4%) were performed in a hospital. After incorporation, 321 implants were used, totalizing R$ 382,339.89, which represents an average increase of 0.5% in the use of LARCs and of portfolio growth of 2.6%. Compared to IUD insertion procedures performed in outpatient and hospital settings, the implant was associated with costs 18.1% and 53.0% lower, respectively, in relation to the average ticket value dispensed. Considering the distribution of insertion sites, the availability of the implant resulted in savings of R$ 170,853.93 and contributed to a 23.4% reduction in IUD-h insertions in a hospital setting.
CONCLUSIONS: The ESI proved to be an effective health management tool, optimizing resource allocation by generating significant cost savings in contraception. The assertive application of HTA (Health Technology Assessment) supported the efficient management of resources and contributed to the sustainability of the complementary health system.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE71
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Reproductive & Sexual Health