IUD May Be Cost-Effective for Preventing Cancer Deaths in Obese Women

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The levonorgestrel intrauterine device may be cost-effective for preventing endometrial cancer in obese women.
The levonorgestrel intrauterine device may be cost-effective for preventing endometrial cancer in obese women.

HealthDay News -- 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, MD, MPH, from the Duke University Medical Center, Durham, North Carolina, 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% reduction in the incidence of endometrial cancer over 5 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% 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.

"The levonorgestrel IUD is a potentially cost-effective strategy for prevention of deaths from endometrial cancer in obese women," the researchers wrote.

Reference

  1. Dottino JA, Hasselblad V, Secord AA, Myers ER, Chino J, Havrilesky LJ. Levonorgestrel intrauterine device as an endometrial cancer prevention strategy in obese women: A cost-effectiveness analysis. Obstet Gynecol. 2016. doi:10.1097/AOG.0000000000001616.
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