Levonorgestrel IUD potentially cost-effective in obese women
(HealthDay)—For obese women, the levonorgestrel intrauterine device (IUD) could be cost-effective for preventing endometrial cancer deaths, according to a study published in the October issue of Obstetrics & Gynecology.
Joseph A. Dottino, M.D., M.P.H., from the Duke University Medical Center in Durham, N.C., and colleagues used a modified Markov model to compare IUD placement at age 50 with usual care among women with a BMI ≥40 or ≥30 kg/m². The authors incorporated the effect of obesity on incidence and survival. The IUD was assumed to confer a 50 percent reduction in the incidence of endometrial cancer over five years; costs of IUD and cancer care were included in the analyses.
The researchers found that the IUD strategy was costlier and more effective than usual care for a 50-year-old with BMI ≥40 kg/m², with a cost-effectiveness ratio of $74,707 per year of life saved. Assuming the protective effect of the levonorgestrel IUD was 10 years, the incremental cost-effectiveness ratio would decrease to $37,858 per life-year saved. In women with BMIs of ≥40 kg/m² or costs less than $500, a levonorgestrel IUD that reduces cancer incidence by at least 68 percent would be cost-effective. The incremental cost-effectiveness ratio of IUD strategy was $137,223 per life-year saved compared with usual care for women with BMI ≥30 kg/m².
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