Economic analysis of long term reversible contraceptives - Focus on Implanon (R)

Objective: To examine the economic impact of a new implantable contraceptiv e, Implanon(R), in comparison with other available contraceptive methods. Design: This was a modelling study using cost data derived from national pu blished sources and effectiveness data from either controlled clinical tria ls (Implanon(R)) or reports in the literature (other contraceptives). In th e baseline analysis, Implanon(R) was compared with 2 long term reversible c ontraceptives, Norplant(R) and Mirena(R). Further analyses were then carrie d out comparing Implanon(R) with Depo-Provera(R) and with combined oral con traceptives. Setting: The study concentrated on the UK, but also made reference to sever al other European countries. Main outcome measures and results: The baseline analysis showed that all 3 long term reversible contraceptives produce very good rates of return, with Implanon(R) providing the best rate of return (both average and internal) of the 3 methods. The payback period for Implanon(R) was calculated as 146 days, compared with 339 and 368 days for Norplant(R) and Mirena(R), respect ively. In terms of cost effectiveness, the cost per protected year for Impl anon(R) was pound 95, compared with pound 146 and pound 168 for Norplant(R) and Mirena(R), respectively. In comparison with Depo-Provera(R) (an inject able contraceptive), Implanon(R) was both less costly and more effective, t he cost per protected year for Depo-Provera(R) being pound 131. The thresho ld beyond which Implanon(R) delivers cost savings compared with combined or al contraceptives was at a failure rate of 4.9% for the combined pill. Conclusions: Reversible long term approaches to contraception provide an ef fective and efficient use of healthcare resources and generate an excellent return on public investment. Implanon(R) produces better rates of return t han both Norplant(R) and Mirena(R), and is also more cost effective in term s of cost per pregnancy avoided and cost per protected year than Norplant(R ), Mirena(R), Depo-Provera(R) and oral contraceptives.