Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.

High rates of unplanned pregnancies persist despite pharmacological developments and advancements in contraceptive methods. Here, we demonstrate that the etonogestrel-releasing subdermal contraceptive implant (IMP-ETN) may be an appropriate and cost-effective alternative to levonorgestrel-releasing...

Full description

Bibliographic Details
Main Authors: Agnaldo Lopes da Silva Filho, Ricardo Luis Pereira Bueno, Yohanna Ramires, Lara Marina Cruz Lino
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0301207&type=printable
_version_ 1797224015059746816
author Agnaldo Lopes da Silva Filho
Ricardo Luis Pereira Bueno
Yohanna Ramires
Lara Marina Cruz Lino
author_facet Agnaldo Lopes da Silva Filho
Ricardo Luis Pereira Bueno
Yohanna Ramires
Lara Marina Cruz Lino
author_sort Agnaldo Lopes da Silva Filho
collection DOAJ
description High rates of unplanned pregnancies persist despite pharmacological developments and advancements in contraceptive methods. Here, we demonstrate that the etonogestrel-releasing subdermal contraceptive implant (IMP-ETN) may be an appropriate and cost-effective alternative to levonorgestrel-releasing intrauterine systems (LNG-IUSs) for women in Brazil. For our pharmacoeconomic analysis, we reviewed the literature on IMP-ETN regarding its acceptance, eligibility criteria, choice, relations with age, adverse events and, finally, the unmet need in the fee-for-service private healthcare sector. We considered qualitative observations in combination with quantitative analysis and performed a deterministic sensitivity analysis to investigate whether this technology can be self-sustainable over a period of five years. The target population for this analysis comprised 158,696 women. Compared with the continued use of LNG-IUSs, adopting the IMP-ETN can result in a cost avoidance of $ 7.640.804,02 in the first year and $ 82,455,254.43 in five years. Disseminating information among physicians will promote this change and strengthen the potential cost avoided by private health system payers. These savings can be used to improve other healthcare programs and strategies. Moreover, the principles of care can be promoted by improving and adapting healthcare systems and expanding treatment and follow-up strategies. This would also provide support to women's reproductive rights and improve their quality of life. Our results suggest that the IMP-ETN has a favorable cost-effectiveness profile. Given all its advantages and negative incremental cost impact over a period of five years, the IMP-ETN may be a more favorable alternative to LNG-IUSs. Therefore, it should be offered to beneficiaries with a private healthcare plan. This analysis overcomes previous barriers to the use of cost-benefit models, and our results may help balance decision-making by policymakers, technical consultants, and researchers.
first_indexed 2024-04-24T13:46:23Z
format Article
id doaj.art-a649fc1df71048e1a6b8cddd72dbe123
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-24T13:46:23Z
publishDate 2024-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-a649fc1df71048e1a6b8cddd72dbe1232024-04-04T05:34:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01193e030120710.1371/journal.pone.0301207Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.Agnaldo Lopes da Silva FilhoRicardo Luis Pereira BuenoYohanna RamiresLara Marina Cruz LinoHigh rates of unplanned pregnancies persist despite pharmacological developments and advancements in contraceptive methods. Here, we demonstrate that the etonogestrel-releasing subdermal contraceptive implant (IMP-ETN) may be an appropriate and cost-effective alternative to levonorgestrel-releasing intrauterine systems (LNG-IUSs) for women in Brazil. For our pharmacoeconomic analysis, we reviewed the literature on IMP-ETN regarding its acceptance, eligibility criteria, choice, relations with age, adverse events and, finally, the unmet need in the fee-for-service private healthcare sector. We considered qualitative observations in combination with quantitative analysis and performed a deterministic sensitivity analysis to investigate whether this technology can be self-sustainable over a period of five years. The target population for this analysis comprised 158,696 women. Compared with the continued use of LNG-IUSs, adopting the IMP-ETN can result in a cost avoidance of $ 7.640.804,02 in the first year and $ 82,455,254.43 in five years. Disseminating information among physicians will promote this change and strengthen the potential cost avoided by private health system payers. These savings can be used to improve other healthcare programs and strategies. Moreover, the principles of care can be promoted by improving and adapting healthcare systems and expanding treatment and follow-up strategies. This would also provide support to women's reproductive rights and improve their quality of life. Our results suggest that the IMP-ETN has a favorable cost-effectiveness profile. Given all its advantages and negative incremental cost impact over a period of five years, the IMP-ETN may be a more favorable alternative to LNG-IUSs. Therefore, it should be offered to beneficiaries with a private healthcare plan. This analysis overcomes previous barriers to the use of cost-benefit models, and our results may help balance decision-making by policymakers, technical consultants, and researchers.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0301207&type=printable
spellingShingle Agnaldo Lopes da Silva Filho
Ricardo Luis Pereira Bueno
Yohanna Ramires
Lara Marina Cruz Lino
Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
PLoS ONE
title Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
title_full Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
title_fullStr Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
title_full_unstemmed Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
title_short Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system.
title_sort etonogestrel releasing subdermal contraceptive implant budget impact analysis based on the brazilian private healthcare system
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0301207&type=printable
work_keys_str_mv AT agnaldolopesdasilvafilho etonogestrelreleasingsubdermalcontraceptiveimplantbudgetimpactanalysisbasedonthebrazilianprivatehealthcaresystem
AT ricardoluispereirabueno etonogestrelreleasingsubdermalcontraceptiveimplantbudgetimpactanalysisbasedonthebrazilianprivatehealthcaresystem
AT yohannaramires etonogestrelreleasingsubdermalcontraceptiveimplantbudgetimpactanalysisbasedonthebrazilianprivatehealthcaresystem
AT laramarinacruzlino etonogestrelreleasingsubdermalcontraceptiveimplantbudgetimpactanalysisbasedonthebrazilianprivatehealthcaresystem