Abstract
Objective
To investigate the 12-month discontinuation rates of levonorgestrel intrauterine system
13.5 mg (LNG-IUS 13.5) and subdermal etonogestrel (ENG) implant in the US.
Study Design
We identified women aged 18–44 who had an insertion of LNG-IUS 13.5 or ENG implant
from the MarketScan Commercial claims database (7/1/2013–9/30/2014). Women were required
to have 12 months of continuous insurance coverage prior to the insertion (baseline)
and at least 12-months after (follow-up). Discontinuation was defined as presence
of an insurance claim for pregnancy-related services, hysterectomy, female sterilization,
a claim for another contraceptive method, or removal of the index contraceptive without
re-insertion within 30 days. Using Cox regression we examined the potential impact
of ENG implant vs. LNG-IUS 13.5 on the likelihood for discontinuation after controlling
for patient characteristics.
Results
A total of 3680 (mean age: 25.4 years) LNG-IUS 13.5 and 23,770 (mean age: 24.6 years)
ENG implant users met the selection criteria. Prior to insertion, 56.6% of LNG-IUS
13.5 and 42.1% of ENG implant users had used contraceptives, with oral contraceptives
being most common (LNG-IUS 13.5: 42.1%; ENG implant: 28.5%). Among users of LNG-IUS
13.5 and ENG implant, rates of discontinuation were similar during the 12-month follow-up
(LNG-IUS 13.5: 24.9%; ENG implant: 24.0%). Regression results showed that women using
LNG-IUS 13.5 vs. ENG implant had similar likelihood for discontinuation (hazard ratio:
0.97, 95% confidence interval: 0.90–1.05, p=.41).
Conclusion
In the real-world US setting, women aged 18–44 using LNG-IUS 13.5 and ENG implant
have similar discontinuation rates after 12 months.
Implications
In the United States, women aged 18–44 using levonorgestrel intrauterine system (13.5
mg) and subdermal etonogestrel implant have similar discontinuation rates after 12
months.
Keywords
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Article info
Publication history
Published online: April 20, 2018
Accepted:
April 6,
2018
Received in revised form:
March 27,
2018
Received:
September 21,
2017
Footnotes
☆Funding: This study and preparation of this manuscript were supported by Bayer HealthCare.
☆☆Conflict of Interest: A Law, R Lynen, L Liao, and A Yaldo are employees of Bayer HealthCare. J Lin is an employee of Novosys Health and served as a paid consultant to Bayer HealthCare.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
