Document Detail

Is it worth paying more for emergency hormonal contraception? The cost-effectiveness of ulipristal acetate versus levonorgestrel 1.5 mg.
MedLine Citation:
PMID:  21067634     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND METHODOLOGY: Emergency hormonal contraception (EHC) can reduce unintended pregnancy and the associated costs and consequences for the individual and National Health Service (NHS). Levonorgestrel (LNG 1.5 mg) is currently the standard of care in the UK; however, it is not licensed for use >72 hours after unprotected sexual intercourse (UPSI). This cost-effectiveness analysis compares LNG 1.5 mg with ulipristal acetate (UPA) (ellaOne(®)), a new emergency hormonal contraceptive that is licensed for use up to 120 hours post-UPSI. The costs of both drugs and the costs of the consequences of unintended pregnancy - namely miscarriage, induced abortion and birth - are compared in a decision model from the perspective of the UK NHS.
RESULTS: The incremental cost-effectiveness ratio (ICER) is the cost of preventing one additional unintended pregnancy with UPA and is calculated to be £311 compared to LNG 1.5 mg when taken up to 120 hours post-UPSI. In sensitivity analysis, looking at different time frames and costs, the ICER ranges from £183 to £500. All these costs are less than the estimated cost of an unintended pregnancy (£948) regardless of the outcome or the cost of an induced abortion (£672).
DISCUSSION AND CONCLUSIONS: Even when considering only the direct costs of an unintended pregnancy, UPA represents value for money as a method of EHC when taken up to 120 hours post-UPSI. UPA is a cost-effective alternative to LNG 1.5 mg for all women presenting for EHC.
Christine M Thomas; Ramona Schmid; Sharon Cameron
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists     Volume:  36     ISSN:  1471-1893     ISO Abbreviation:  J Fam Plann Reprod Health Care     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2010-12-30     Revised Date:  2011-05-10    
Medline Journal Info:
Nlm Unique ID:  101087687     Medline TA:  J Fam Plann Reprod Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  197-201     Citation Subset:  IM    
Tomac Consultancy Services Ltd, Cambridge, UK.
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MeSH Terms
Contraceptive Agents, Female / economics*
Contraceptives, Postcoital / economics*
Cost-Benefit Analysis / economics*
Great Britain
Levonorgestrel / economics*
Norpregnadienes / economics*
Pregnancy, Unplanned
Reg. No./Substance:
0/Contraceptive Agents, Female; 0/Contraceptives, Postcoital; 0/Norpregnadienes; 0/ulipristal; 797-63-7/Levonorgestrel
Comment In:
J Fam Plann Reprod Health Care. 2011 Apr;37(2):121-2; author reply 122-3   [PMID:  21454278 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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