Limits...
The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France.

Schmid R - PLoS ONE (2015)

Bottom Line: The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model.In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel.When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies.

View Article: PubMed Central - PubMed

Affiliation: HRA Pharma, Paris, France.

ABSTRACT

Objective: To evaluate the cost-effectiveness of ulipristal acetate and levonorgestrel in minors in France, and analyze whether it is worthwhile to provide ulipristal acetate to minors free of charge.

Methods: The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model. Pregnancy rates, outcomes of unintended pregnancies, and resource utilization were derived from the literature. Resources and their costs were considered until termination or a few days after delivery. Deterministic and probabilistic sensitivity analyses were performed.

Results: The cost of an unintended pregnancy in a French minor is estimated to be 1,630 € (range 1,330 € - 1,803 €). Almost 4 million € (3.1 € - 13.7 € million) in unintended pregnancy spending in 2010 could have been saved by the use of ulipristal acetate instead of levonorgestrel. The incremental cost of ulipristal acetate compared to levonorgestrel is 3.30 € per intake, or 418 € per pregnancy avoided (intake within 72 hours). In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel.

Conclusions: Ulipristal acetate dominates levonorgestrel when taken within 24 hours after unprotected intercourse, i.e., it is more effective at a lower cost. When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies. In the light of these findings, it is worthwhile to provide free access to minors.

No MeSH data available.


Related in: MedlinePlus

Two-way sensitivity analysis of the pregnancy rates of ulipristal acetate and levonorgestrel.UPA, ulipristal acetate; LNG, levonorgestrel; EHC, emergency hormonal contraception; Note: The colored area indicates which method is more cost-effective at a given pregnancy rate of UPA and LNG (for instance UPA is more cost-effective when the pregnancy rate of UPA is less than 1.36% and the pregnancy rate of LNG is more than 2.15% at intake within 72 hours). The dotted lines indicate the pregnancy rates observed in clinical trials, the whole area covers the 95% confidence intervals.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4589416&req=5

pone.0138990.g002: Two-way sensitivity analysis of the pregnancy rates of ulipristal acetate and levonorgestrel.UPA, ulipristal acetate; LNG, levonorgestrel; EHC, emergency hormonal contraception; Note: The colored area indicates which method is more cost-effective at a given pregnancy rate of UPA and LNG (for instance UPA is more cost-effective when the pregnancy rate of UPA is less than 1.36% and the pregnancy rate of LNG is more than 2.15% at intake within 72 hours). The dotted lines indicate the pregnancy rates observed in clinical trials, the whole area covers the 95% confidence intervals.

Mentions: In the two-way analysis, two parameters are varied at the same time. The pregnancy rates of both drugs are varied, using confidence intervals as indicated in Table 1. Fig 2 shows that ulipristal acetate remains the dominant method in the majority of cases.


The Cost-Effectiveness of Emergency Hormonal Contraception with Ulipristal Acetate versus Levonorgestrel for Minors in France.

Schmid R - PLoS ONE (2015)

Two-way sensitivity analysis of the pregnancy rates of ulipristal acetate and levonorgestrel.UPA, ulipristal acetate; LNG, levonorgestrel; EHC, emergency hormonal contraception; Note: The colored area indicates which method is more cost-effective at a given pregnancy rate of UPA and LNG (for instance UPA is more cost-effective when the pregnancy rate of UPA is less than 1.36% and the pregnancy rate of LNG is more than 2.15% at intake within 72 hours). The dotted lines indicate the pregnancy rates observed in clinical trials, the whole area covers the 95% confidence intervals.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4589416&req=5

pone.0138990.g002: Two-way sensitivity analysis of the pregnancy rates of ulipristal acetate and levonorgestrel.UPA, ulipristal acetate; LNG, levonorgestrel; EHC, emergency hormonal contraception; Note: The colored area indicates which method is more cost-effective at a given pregnancy rate of UPA and LNG (for instance UPA is more cost-effective when the pregnancy rate of UPA is less than 1.36% and the pregnancy rate of LNG is more than 2.15% at intake within 72 hours). The dotted lines indicate the pregnancy rates observed in clinical trials, the whole area covers the 95% confidence intervals.
Mentions: In the two-way analysis, two parameters are varied at the same time. The pregnancy rates of both drugs are varied, using confidence intervals as indicated in Table 1. Fig 2 shows that ulipristal acetate remains the dominant method in the majority of cases.

Bottom Line: The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model.In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel.When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies.

View Article: PubMed Central - PubMed

Affiliation: HRA Pharma, Paris, France.

ABSTRACT

Objective: To evaluate the cost-effectiveness of ulipristal acetate and levonorgestrel in minors in France, and analyze whether it is worthwhile to provide ulipristal acetate to minors free of charge.

Methods: The cost-effectiveness of two emergency contraceptive methods was compared based on a decision-analytical model. Pregnancy rates, outcomes of unintended pregnancies, and resource utilization were derived from the literature. Resources and their costs were considered until termination or a few days after delivery. Deterministic and probabilistic sensitivity analyses were performed.

Results: The cost of an unintended pregnancy in a French minor is estimated to be 1,630 € (range 1,330 € - 1,803 €). Almost 4 million € (3.1 € - 13.7 € million) in unintended pregnancy spending in 2010 could have been saved by the use of ulipristal acetate instead of levonorgestrel. The incremental cost of ulipristal acetate compared to levonorgestrel is 3.30 € per intake, or 418 € per pregnancy avoided (intake within 72 hours). In the intake within 24 hours subgroup, ulipristal acetate was found to be more efficacious at a lower cost compared to levonorgestrel.

Conclusions: Ulipristal acetate dominates levonorgestrel when taken within 24 hours after unprotected intercourse, i.e., it is more effective at a lower cost. When taken within 72 hours, ulipristal acetate is a cost- effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of these pregnancies. In the light of these findings, it is worthwhile to provide free access to minors.

No MeSH data available.


Related in: MedlinePlus