DRIVERS AND IMPACT OF EARLY REMOVAL OF LONG-ACTING REVERSIBLE CONTRACEPTIVE (LARC) ON RESOURCE UTILIZATION IN A BRAZILIAN HEALTH INSURANCE PROVIDER
Author(s)
Victor Rosell, Bachelor1, Ricardo Saad, MSc2, Maria Auxiliadora Budib, Master3, Elea Oliveira De Godoy, .4.
1Bayer, São Paulo, Brazil, 2Bayer SA, Sao Paulo, Brazil, 3Cassems, Mato Grosso do SUl, Brazil, 4Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil.
1Bayer, São Paulo, Brazil, 2Bayer SA, Sao Paulo, Brazil, 3Cassems, Mato Grosso do SUl, Brazil, 4Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil.
OBJECTIVES: To characterize the usage profile of LARCs (levonorgestrel intrauterine device [LNG-IUD], etonogestrel subdermal implant [ENG-IMP], and non-hormonal IUD [IUD]) among beneficiaries of a Brazilian health insurance, with emphasis on insertion patterns, reasons for removal and method-to-method switches due to non-adaptability.
METHODS: A Retrospective review was conducted on medical authorization requests submitted to the HMO over a 36-month period, from April 2023 to March 2026. Anonymized records of LARC insertions and removals solicitation were extracted and analyzed. Reasons for removal were categorized as: (1) end of label approved duration, (2) non-adaptability to the method, and (3) other reasons (desire to conceive, misinsertion). We additionally quantified the number of switches from one LARC to another attributed to non-adaptability.
RESULTS: A total of 7,971 LARC insertions procedures and 448 removals procedures were analyzed, representing 3,638 unique patients in three years. ENG-IMP showed a higher non-adaptability removal rate (14.17%) compared with the LNG-IUD (7.84%). Among women who did not adapt to the implant, 38.89% subsequently had a LNG-IUS inserted, and 11.11% did the opposite, inserted a LNG-IUS and changed to ENG-IMP, generating a duplicated cost for the health plan. End of label approved duration was the reason of 62.75%, 59.84% and 45.83% of removals from LNG-IUD, EMP-IMP and IUD, meanwhile other reasons were responsible for 26.47%, 25.98% and 18.75%. Mean age of women who had a LARC was 33 years old (yo) (LNG-IUD: 35 yo, EMP-IMP: 29 yo; IUD: 33 yo).
CONCLUSIONS: The ENG-IMP presented a higher non-adaptability removal rate than the LNG-IUD, and a relevant proportion of these cases required a subsequent LARC insertion, resulting in duplicated costs for the health insurance. Therefore, detailed contraceptive counseling is essential to determine the best method for each woman, aligned with individual expectations.
METHODS: A Retrospective review was conducted on medical authorization requests submitted to the HMO over a 36-month period, from April 2023 to March 2026. Anonymized records of LARC insertions and removals solicitation were extracted and analyzed. Reasons for removal were categorized as: (1) end of label approved duration, (2) non-adaptability to the method, and (3) other reasons (desire to conceive, misinsertion). We additionally quantified the number of switches from one LARC to another attributed to non-adaptability.
RESULTS: A total of 7,971 LARC insertions procedures and 448 removals procedures were analyzed, representing 3,638 unique patients in three years. ENG-IMP showed a higher non-adaptability removal rate (14.17%) compared with the LNG-IUD (7.84%). Among women who did not adapt to the implant, 38.89% subsequently had a LNG-IUS inserted, and 11.11% did the opposite, inserted a LNG-IUS and changed to ENG-IMP, generating a duplicated cost for the health plan. End of label approved duration was the reason of 62.75%, 59.84% and 45.83% of removals from LNG-IUD, EMP-IMP and IUD, meanwhile other reasons were responsible for 26.47%, 25.98% and 18.75%. Mean age of women who had a LARC was 33 years old (yo) (LNG-IUD: 35 yo, EMP-IMP: 29 yo; IUD: 33 yo).
CONCLUSIONS: The ENG-IMP presented a higher non-adaptability removal rate than the LNG-IUD, and a relevant proportion of these cases required a subsequent LARC insertion, resulting in duplicated costs for the health insurance. Therefore, detailed contraceptive counseling is essential to determine the best method for each woman, aligned with individual expectations.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD145
Topic
Clinical Outcomes, Medical Technologies, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Reproductive & Sexual Health