Laura Rogers: The Intrauterine Device in Women of Childbearing Age Has A Greater Long-Term Cost-Benefit than Oral Contraception Pills

The Intrauterine Device in Women of Childbearing Age Has A Greater Long-Term Cost-Benefit than Oral Contraception Pills

 ABSTRACT

Background: Unplanned pregnancy remains a major problem in the United States, despite the widespread usage of contraception. Improper and inconsistent usage of short acting reversible contraception contributes to the unplanned pregnancy epidemic. Hormonal and copper intrauterine devices are safe and effective alternatives, but usage in the Unites States remains low.

Methods: An extensive search of MEDLINE-Ovid, CINAHL, and Web of Science was conducted. Keyword terms included: long-acting reversible contraception, contraception, cost effectiveness, and levonorgestrel-releasing intrauterine system. The studies were limited to the English language and those done on humans. Only publications from the last fifteen years were considered. The articles were further limited to studies done in the United States. References of articles were reviewed for further sources.

Results: A total of 47 articles were reviewed and three met inclusion criteria. The first two studies were economic analyses of the use of hormonal IUDs. The third study is a retrospective cohort which included an economic analysis. Two of the studies were funded in part by Bayer, a drug company that has a vested interest in IUDs being cost-effective. The quality of the data remains high.

Conclusion: The hormonal and copper intrauterine devices are safer, more cost effective alternatives to oral contraceptive pills. They require a one-time insertion and last for several years. They allow the user privacy and peace of mind, while approaching effectiveness levels of sterilization.

Keywords: long-acting reversible contraception, contraception, cost effectiveness, and levonorgestrel-releasing intrauterine system (LNG-IUS).

REVIEWED STUDIES:

Trussell J, Henry N, Hassan F, Prezioso A, Law A, Filonenko A. Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception. Contraception. 2013;87:154-161.

Trussell J, Hassan F, Lowin J, Law A, Filonenko A. Achieving cost-neutrality with long-acting reversible contraceptive methods. Contraception. 2015;91:49-56.

Rodriguez MI, Caughey AB, Edelman A, Darney PD, Foster DG. Cost-benefit analysis of state- and hospital-funded postpartum intrauterine contraception at a university hospital for recent immigrants to the United States.Contraception. 2010;81:304-308..

AUTHOR:  Laura Rogers is currently completing her second year in the School of PA Studies at Pacific University, Oregon.  She will graduate with an MS in Physician Assistant Studies in August, 2016.