OBJECTIVES:

The Long-Acting Reversible Contraceptive (LARC) methods are recognised for their high efficacy rates and are widely prescribed throughout the UK. Despite their high upfront costs for treatment initiation, NICE deemed LARC methods to be more cost-effective than oral contraceptive pills even at one year of use (NICE CG30 2005). Further research is needed to assess the implications on unintended pregnancies and financial impact between two of the most commonly prescribed LARC methods, the etonogestrel implant and the medroxyprogesterone acetate injectable.

METHODS:

A 3 year time-horizon cost-comparison analysis was developed to assess the budgetary impact of using the implant compared to the injectable. The outcomes estimated are the difference in the number of unintended pregnancies and the associated financial impact. To facilitate comparison of the outcomes between these contraceptives, it is assumed that women are equally using the implant and the injectable. The calculation of the number of unintended pregnancies was based on typical failure rate for both methods.

RESULTS:

Using 2016 data, approximately 685,075 women aged 16-49 in the UK received either the implant or the injectable. Based on typical failure rates and equal usage of method, it is expected that over a three year period 52 and 1,028 unintended pregnancies will occur in women using the implant and the injectable respectively. Use of the implant versus the injectable resulted in 976 fewer unintended pregnancies and realised financial savings of £57,276,103; of which £55,680,715 is attributable to treatment costs (ingredient, consultations, removal/insertion costs) and £1,595,388 to the cost of unintended pregnancies (live birth, miscarriage, abortion, ectopic pregnancy).

CONCLUSIONS:

Although assuming equal shares between the implant and the injectable may not accurately reflect clinical practice; these results support the implementation of policies to increase the number of women on implants versus injectable to further prevent unintended pregnancies and realise associated cost savings.