October 15, 2019
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Same-day LARC for teens saves $2,000 per patient

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Providing teenagers with same-day long-acting reversible contraception, or LARC, saved more than $2,000 per Medicaid patient in the United States vs. placement at a subsequent visit, according to an economic evaluation that appeared in JAMA Network Open.

Unintended pregnancies among U.S. adolescents cost an estimated $21 billion annually, Tracey A. Wilkinson, MD, MPH, assistant professor of pediatrics at the Indiana University School of Medicine, and colleagues wrote.

“Given the costs of unintended pregnancy and short interpregnancy intervals for Medicaid in particular, which serves a vulnerable population at particularly high risk for adverse pregnancy outcomes, we sought to examine the net cost of providing same-day LARC from a Medicaid payer perspective,” they added.

To estimate the savings of same-day LARC, Wilkinson and colleagues developed a decision model based on a 16-year-old patient who presented for care asking for that form of contraception.

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Providing teenagers with same-day long-acting reversible contraception saved more than $2,000 per Medicaid patient in the U.S. vs. placement at a subsequent visit, according to an article in JAMA Network Open.

With the option that scheduled a return visit for the patient to have the LARC put in place, researchers accounted for her making and not making her appointment, her choosing to continue to with LARC or have it removed, her becoming pregnant or not, her choosing to end the pregnancy, her miscarrying. her giving birth preterm or term and her method of giving birth.

Their analysis showed that over a 1-year period, placing the LARC on the same appointment day cost less than placing the device at a subsequent visit ($2,016 per patient vs. $4,133 per patient, respectively).

In addition, same-day LARC was associate with a lower unintended pregnancy rate (14% vs. 48%) and abortion rate (4% vs. 14%) vs. placing the contraception on a later date.

“The cost savings calculated here provide a benchmark for policymakers to consider potential policy changes and investments in incentives to promote and provide same-day LARC,” Wilkinson and colleagues wrote. – by Janel Miller

Disclosures: Wilkinson reports being the Young People’s co-chair for the Oral Contraceptives, Over-the-Counter Working Group and receiving reimbursement for travel and an annual fee for this work. Please see the study for all other authors’ relevant financial disclosures.