OBJECTIVES: Mexico is one of the countries with the highest rate of teen pregnancy in the world, with 66 pregnancies per 1,000 teens every year. Thus, long-acting contraceptive methods become relevant as they might help in reducing this rate and the associated economic and social burden of teen pregnancy. Currently, two subdermal implants are available in the public health institutions: levonorgestrel and etonorgestrel, which differ in duration of coverage, discontinuation rates and price. The objective is To assess the cost effectiveness of covering teenagers with levonorgestrel or etonorgestrel in Mexico

METHODS: A cost effectiveness analysis was developed to estimate the Incremental Cost Effectiveness Ratio associated with using levonorgestrel vs etonorgestrel to meet the contraceptive needs of teens. A phase 3 study comparing the two alternatives was used to support the analysis and a decision tree model was developed in MicrosoftExcel®2013 to simulate 1,000 teenagers. The analysis was conducted under the public payer´s perspective, hence only direct medical costs were considered. Prices were gathered from Mexican official sources as of April 2023. The analysis was conducted under a 5-year temporal horizon to capture the difference in implants duration. A 5% annual discount rate was applied according to Mexican guidelines.

RESULTS: The analysis showed that levonorgestrel offers 598 extra years of coverage with savings up to $870,301 MXN vs etonorgestrel. Thus, the analysis suggests that levonorgestrel is a dominant alternative

CONCLUSIONS: From the perspective of the Mexican public payer, the results suggests that levonorgestrel is a dominant alternative vs etonorgestrel to cover Mexican teenagers against unplanned pregnancy.