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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

Cost-effectiveness plane of ulipristal acetate versus levonorgestrel (intake within 72 hours).WTP, willingess-to-pay, defined as the cost of an unintended pregnancy; UPA, ulipristal acetate; LNG, levonorgestrel. Note: in the upper-right quadrant, UPA costs more and is more effective than LNG; in the lower-right quadrant, UPA costs less and is more effective. UPA is cost-effective for all iterations below the WTP threshold.
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pone.0138990.g003: Cost-effectiveness plane of ulipristal acetate versus levonorgestrel (intake within 72 hours).WTP, willingess-to-pay, defined as the cost of an unintended pregnancy; UPA, ulipristal acetate; LNG, levonorgestrel. Note: in the upper-right quadrant, UPA costs more and is more effective than LNG; in the lower-right quadrant, UPA costs less and is more effective. UPA is cost-effective for all iterations below the WTP threshold.

Mentions: The result of the probabilistic sensitivity analysis is presented in the form of a cost-effectiveness plane in Fig 3. The majority of the results after 10,000 iterations were below the willingness-to-pay threshold of 1,630.10 € (the cost of an unintended pregnancy), indicating that the results are robust. Ulipristal acetate was the preferred method in 76.9% of cases and was found to be superior to levonorgestrel in 45%, meaning it was more effective at a lower cost.


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

Schmid R - PLoS ONE (2015)

Cost-effectiveness plane of ulipristal acetate versus levonorgestrel (intake within 72 hours).WTP, willingess-to-pay, defined as the cost of an unintended pregnancy; UPA, ulipristal acetate; LNG, levonorgestrel. Note: in the upper-right quadrant, UPA costs more and is more effective than LNG; in the lower-right quadrant, UPA costs less and is more effective. UPA is cost-effective for all iterations below the WTP threshold.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0138990.g003: Cost-effectiveness plane of ulipristal acetate versus levonorgestrel (intake within 72 hours).WTP, willingess-to-pay, defined as the cost of an unintended pregnancy; UPA, ulipristal acetate; LNG, levonorgestrel. Note: in the upper-right quadrant, UPA costs more and is more effective than LNG; in the lower-right quadrant, UPA costs less and is more effective. UPA is cost-effective for all iterations below the WTP threshold.
Mentions: The result of the probabilistic sensitivity analysis is presented in the form of a cost-effectiveness plane in Fig 3. The majority of the results after 10,000 iterations were below the willingness-to-pay threshold of 1,630.10 € (the cost of an unintended pregnancy), indicating that the results are robust. Ulipristal acetate was the preferred method in 76.9% of cases and was found to be superior to levonorgestrel in 45%, meaning it was more effective at a lower cost.

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