| Popis: |
A comparison of the relative costs of the injectable contraceptive (depot medroxyprogesterone acetate) and the hormonal implant (Norplant) indicates that the implant is a less costly contraceptive option when it is used for its full five-year lifespan. Over a five-year period, the implant costs $107 annually, compared with $140 per year for the injectable. However, if a woman discontinues the implant before she has used it for at least four years, the injectable becomes the less costly option. Relatively high continuation rates--around 95% annually--are necessary to make the implant the more cost-effective contraceptive method.The authors compared the relative costs of the injectable contraceptive depot medroxyprogesterone acetate (Depo-Provera) and the hormonal implant Norplant. Per-year costs for the implant were calculated using both published and theoretical yearly continuation rates. Woman-years of contraceptive use were then calculated to project the costs for a theoretical cohort of 100 women, and these costs were compared to the cost of Depo-Provera. Costs for the implant were $433.25 per insertion and $100.29 per removal based upon Current Procedural Terminology codes 11975 and 11976, and on Colorado Medicaid reimbursement rates for the two codes. The average Medicaid reimbursement in the US has been reported to be $466 for implant insertion and $90 for removal. The $35.19 cost of the injectable was based upon Current Procedural Terminology code X5560 and on the Colorado Medicaid reimbursement rate. Actual office charges are typically higher than medicaid reimbursement, so the costs reviewed in this analysis represent a low estimate, especially for the implant. It is also noted that many insurance companies will pay for neither contraceptive method. The analysis found Norplant to be the less costly of the two methods when used for its full five-year lifespan. Over a five-year period the implant costs $107 annually, compared with $140 per year for the injectable. If a woman discontinues the implant before she has used it for at least four years, however, the injectable becomes the less costly option. Annual continuation rates of approximately 95% are needed to make Norplant the more cost-effective of the two contraceptive methods. |
