Cost-Effectiveness of Long-Acting Progestogens vs. Combined Oral Contraceptives
Study Overview
This study evaluates the cost-effectiveness of long-acting progestogens (LAP), such as the levonorgestrel-releasing intrauterine system (LNG-IUS) and depot-medroxyprogesterone acetate (DMPA), compared to the combined oral contraceptive pill (COCP) for preventing endometriosis-related pain after surgery.
Key Details
- Design: Economic evaluation alongside a randomized controlled trial.
- Setting: Conducted in 34 hospitals across the UK from November 2015 to March 2019.
- Participants: 405 women aged 16-45 undergoing surgery for endometriosis.
- Interventions: Participants were randomly assigned to receive either LAPs or COCP.
Main Findings
The analysis showed:
- The COCP group had an additional cost of £533 per woman compared to LAPs.
- COCP provided an additional 0.031 QALYs (Quality-Adjusted Life Years) over 36 months.
- The cost-effectiveness ratio for COCP was approximately £17,193 per QALY.
- There is a 54.7% probability that COCP is cost-effective at the £20,000/QALY threshold.
- Secondary analyses favored LAPs, indicating they may be a better option for some women.
Conclusion
While COCP shows a slightly higher chance of being cost-effective, the differences in outcomes between LAPs and COCP are minimal. LAPs may be preferable due to lower rates of further surgeries and additional treatments.
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