Economic Burden of Contraception Management in Spain

**Background:** A wide variety of contraceptive methods are available, some of them reimbursed by the Spanish National Health System (SNHS). However, the number of unintended pregnancies (UP) is still significant, leading to a high economic burden, mainly derived from non-adherence to and the incorr...

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Main Authors: Inmaculada Parra Ribes, Juan José Rascón Poza, Ezequiel Pérez Campos, Ignacio Bugella Yudice, Maria Jesús Rodríguez Domingo
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2018-04-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/9785
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author Inmaculada Parra Ribes
Juan José Rascón Poza
Ezequiel Pérez Campos
Ignacio Bugella Yudice
Maria Jesús Rodríguez Domingo
author_facet Inmaculada Parra Ribes
Juan José Rascón Poza
Ezequiel Pérez Campos
Ignacio Bugella Yudice
Maria Jesús Rodríguez Domingo
author_sort Inmaculada Parra Ribes
collection DOAJ
description **Background:** A wide variety of contraceptive methods are available, some of them reimbursed by the Spanish National Health System (SNHS). However, the number of unintended pregnancies (UP) is still significant, leading to a high economic burden, mainly derived from non-adherence to and the incorrect use of contraceptive methods. **Objectives:** This study aims to estimate the economic burden associated with reversible contraception management in Spain, from the perspectives of both the SNHS and women, over a 5-year period. **Methods:** A survey was performed to identify contraception management in Spain based on the experience of a panel of six expert gynecologists. An economic model was conducted to quantify the current burden of contraception according to healthcare resources use over 5 years. The costs included in the analysis were diagnostic tests, initial and follow-up consultations, methods acquisition costs, and UP derived from therapy failure. **Results:** Reversible contraception costs in Spain amount to €12.5 billion over a 5–year period. Condoms and combined oral contraceptives (COC) account for 86.8% of the total cost and the other methods only 13.2%. There are differences in contraceptive use according to women’s age. Short-acting reversible contraceptives (SARC) such as COC, condom and vaginal ring, are most commonly used by younger women. However, SARC are correlated with the highest failure rate, resulting in over €7.2 billion cost, explained by the high number of UP. Long-acting reversible contraceptives (LARC), such as the levonorgestrel-releasing intrauterine system (LNG-IUS20), implant and copper intrauterine devices (IUD), are selected by women over 35 years of age due to user-independent compliance. SARC methods result in a higher cost per woman over 5 years: vaginal ring €2427.8, patch €2402.6, condom €2060.1 and COC €1895.1; while LARC methods are the most economic option per women: LNG-IUS20 €630.4, copper IUD €658.2, LNG-IUS12 €703.8, intramuscular injectable €907.8 and implant €940.5. **Conclusions:** LARC methods result in lower costs compared with SARC options from the perspectives of the SNHS and women, explained by user-independent compliance, preventing a significant number of UP and its elevated economic burden. An increased LARC methods use could avoid UP events, leading to significant cost-savings for the SNHS.
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spelling doaj-art-08ecff2a4dc145cca3f341844623188f2025-02-10T16:13:07ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362018-04-0161Economic Burden of Contraception Management in SpainInmaculada Parra RibesJuan José Rascón PozaEzequiel Pérez CamposIgnacio Bugella YudiceMaria Jesús Rodríguez Domingo**Background:** A wide variety of contraceptive methods are available, some of them reimbursed by the Spanish National Health System (SNHS). However, the number of unintended pregnancies (UP) is still significant, leading to a high economic burden, mainly derived from non-adherence to and the incorrect use of contraceptive methods. **Objectives:** This study aims to estimate the economic burden associated with reversible contraception management in Spain, from the perspectives of both the SNHS and women, over a 5-year period. **Methods:** A survey was performed to identify contraception management in Spain based on the experience of a panel of six expert gynecologists. An economic model was conducted to quantify the current burden of contraception according to healthcare resources use over 5 years. The costs included in the analysis were diagnostic tests, initial and follow-up consultations, methods acquisition costs, and UP derived from therapy failure. **Results:** Reversible contraception costs in Spain amount to €12.5 billion over a 5–year period. Condoms and combined oral contraceptives (COC) account for 86.8% of the total cost and the other methods only 13.2%. There are differences in contraceptive use according to women’s age. Short-acting reversible contraceptives (SARC) such as COC, condom and vaginal ring, are most commonly used by younger women. However, SARC are correlated with the highest failure rate, resulting in over €7.2 billion cost, explained by the high number of UP. Long-acting reversible contraceptives (LARC), such as the levonorgestrel-releasing intrauterine system (LNG-IUS20), implant and copper intrauterine devices (IUD), are selected by women over 35 years of age due to user-independent compliance. SARC methods result in a higher cost per woman over 5 years: vaginal ring €2427.8, patch €2402.6, condom €2060.1 and COC €1895.1; while LARC methods are the most economic option per women: LNG-IUS20 €630.4, copper IUD €658.2, LNG-IUS12 €703.8, intramuscular injectable €907.8 and implant €940.5. **Conclusions:** LARC methods result in lower costs compared with SARC options from the perspectives of the SNHS and women, explained by user-independent compliance, preventing a significant number of UP and its elevated economic burden. An increased LARC methods use could avoid UP events, leading to significant cost-savings for the SNHS.https://doi.org/10.36469/9785
spellingShingle Inmaculada Parra Ribes
Juan José Rascón Poza
Ezequiel Pérez Campos
Ignacio Bugella Yudice
Maria Jesús Rodríguez Domingo
Economic Burden of Contraception Management in Spain
Journal of Health Economics and Outcomes Research
title Economic Burden of Contraception Management in Spain
title_full Economic Burden of Contraception Management in Spain
title_fullStr Economic Burden of Contraception Management in Spain
title_full_unstemmed Economic Burden of Contraception Management in Spain
title_short Economic Burden of Contraception Management in Spain
title_sort economic burden of contraception management in spain
url https://doi.org/10.36469/9785
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AT ezequielperezcampos economicburdenofcontraceptionmanagementinspain
AT ignaciobugellayudice economicburdenofcontraceptionmanagementinspain
AT mariajesusrodriguezdomingo economicburdenofcontraceptionmanagementinspain