Original Title: Dispositivo intrauterino liberador de levonorgestrel en mujeres en edad fértil como método anticonceptivo.

Authors' recommendations: "Conclusions Low-quality evidence suggests that the levonorgestrel-releasing intrauterine device may yield a considerable net benefit, when compared to non-hormonal intrauterine devices ≤ 250 mm2, for women of childbearing age without associated diseases, because it decreases the probability of unwanted pregnancy during the first five years of use. Concomitantly, the adherence, expulsion and the adverse events rates are similar for both devices. Moderate-quality evidence shows that the levonorgestrel-releasing intrauterine device, when compared to non-hormonal intrauterine devices > 250 mm2 or other hormonal contraceptives for women of childbearing age without related diseases, probably yields a net marginal benefit because no differences have been found among unwanted pregnancy rates, adherence rates and planned pregnancy rates after the device removal. Likewise, the serious adverse events rate is similar between comparators. Among the reviewed practice guidelines, most of them agree on recommending the levonorgestrel-releasing intrauterine device as a long-acting contraceptive method as long as no contraindications are presented and they also highlight that the patient's decision is the most important factor in device selection. Among the coverage policies reviewed in Latin America, Brazil does not provide coverage for the levonorgestrel-releasing intrauterine device, whereas the rest of the reviewed countries do not assess the coverage of this device. Regarding the policies of high-income countries, Australia, Canada, France and the United States provide coverage, although in the case of some private funders it solely depends on the plan that was hired by the beneficiary. The levonorgestrel-releasing intrauterine device is included in the Compulsory Medical Program, but indicated for women with previous diseases. The National Sexual Health and Responsible Procreation Program's law in Argentina does not mention the use of this device. Economic evaluations in high-income countries have shown that this technology is sometimes cost-effective when compared to combined oral contraceptives. However, it was not cost-effective when compared to non-hormonal intrauterine devices. In Brazil, when non-hormonal intrauterine devices were used over other long-acting contraceptive methods, the budget impact was favorable."

Project Status: Completed

URL for project: https://ets.iecs.org.ar/publication/2107

Year Published: 2023

URL for published report: https://ets.iecs.org.ar/publication/2107

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>