{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:51:48Z","timestamp":1774482708492,"version":"3.50.1"},"reference-count":35,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":2040,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Long-acting reversible contraception (LARC) is the most effective form of reversible contraception, but its use in Australia is low compared with other countries. The aim of this study was to evaluate the economic effect of an increase in LARC uptake to international rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An economic model was designed to assess two scenarios, namely increasing the current rate of LARC uptake of 12.5% to the international benchmark of 14.8% among: (1) women currently using the oral contraceptive pill (OCP); and (2) women at risk of pregnancy and not using contraception. Model inputs included cost of contraceptive methods, discontinuation rates and abortion and miscarriage costs associated with unintended pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women who switch from an OCP to LARC would save A$114\u2013157 per year. Those not currently using any contraception who adopt LARC would incur costs of A$36\u2013194 per year, but would reap savings from the reduction in unintended pregnancies. Over 5 years there would be a net saving of A$74.4 million for Scenario 1 and A$2.4 million for Scenario 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Greater use of LARC would result in a net gain in economic benefits to Australia. These benefits are largely driven by women switching from an OCP to LARC who have reduced costs, as well as women wishing to avoid pregnancy who choose to use LARC rather than no method. This evidence will support women making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What is known about the topic?<\/jats:title>\n                    <jats:p>LARC is the most effective form of reversible contraception, but uptake in Australia is relatively low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What does this paper add?<\/jats:title>\n                    <jats:p>There are economic benefits to society for women who switch from an OCP to LARC, as well as for women who switch from no contraception to LARC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What are the implications for practitioners?<\/jats:title>\n                    <jats:p>The findings of this study will support women in making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/ah18190","type":"journal-article","created":{"date-parts":[[2019,10,27]],"date-time":"2019-10-27T17:30:27Z","timestamp":1572197427000},"page":"385-391","source":"Crossref","is-referenced-by-count":11,"title":["Cost\u2013benefit analysis of enhancing the uptake of long-acting reversible contraception in Australia"],"prefix":"10.1071","volume":"44","author":[{"given":"Kristine","family":"Concepcion","sequence":"first","affiliation":[{"name":"AFamily Planning NSW, 328\u2013336 Liverpool Road, Ashfield, NSW 2131, Australia. Email: kris.alba@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarina","family":"Lacey","sequence":"additional","affiliation":[{"name":"BThe Centre for International Economics, Level 7, 8 Spring Street, Sydney, NSW 2000, Australia. Email: slacey@thecie.com.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"McGeechan","sequence":"additional","affiliation":[{"name":"AFamily Planning NSW, 328\u2013336 Liverpool Road, Ashfield, NSW 2131, Australia. Email: kris.alba@gmail.com"},{"name":"CSchool of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Sydney, NSW 2006, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Estoesta","sequence":"additional","affiliation":[{"name":"AFamily Planning NSW, 328\u2013336 Liverpool Road, Ashfield, NSW 2131, Australia. Email: kris.alba@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Bateson","sequence":"additional","affiliation":[{"name":"AFamily Planning NSW, 328\u2013336 Liverpool Road, Ashfield, NSW 2131, Australia. Email: kris.alba@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Botfield","sequence":"additional","affiliation":[{"name":"AFamily Planning NSW, 328\u2013336 Liverpool Road, Ashfield, NSW 2131, Australia. Email: kris.alba@gmail.com"},{"name":"DCorresponding author. Email: jessicab@fpnsw.org.au"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"key":"2025121500501487800_R1","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1056\/NEJMoa1110855","article-title":"Effectiveness of long-acting reversible contraception.","volume":"366","author":"Winner","year":"2012","journal-title":"N Engl J Med"},{"key":"2025121500501487800_R2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1363\/psrh.12017","article-title":"Contraceptive failure in the United States: estimates from the 2006\u20132010 National Survey of Family Growth.","volume":"49","author":"Sundaram","year":"2017","journal-title":"Perspect Sex Reprod Health"},{"key":"2025121500501487800_R3"},{"key":"2025121500501487800_R4","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.contraception.2016.06.016","article-title":"Contraceptive practices among women: the Second Australian Study of Health and Relationships.","volume":"5","author":"Richters","year":"2016","journal-title":"Contraception"},{"key":"2025121500501487800_R5"},{"key":"2025121500501487800_R6","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1111\/ajo.12587","article-title":"Current barriers and potential strategies to increase the use of long-acting reversible contraception (LARC) to reduce the rate of unintended pregnancies in Australia: an expert roundtable discussion.","volume":"57","author":"Mazza","year":"2017","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025121500501487800_R7","doi-asserted-by":"publisher","first-page":"115.e1","DOI":"10.1016\/j.ajog.2010.04.017","article-title":"The contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.","volume":"203","author":"Secura","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"2025121500501487800_R8","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1136\/jfprhc-2014-100878","article-title":"Cost of unintended pregnancy in Norway: a role for long-acting reversible contraception.","volume":"41","author":"Henry","year":"2015","journal-title":"J Fam Plann Reprod Health Care"},{"key":"2025121500501487800_R9","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1093\/humrep\/den091","article-title":"The cost-effectiveness of long-acting reversible contraceptive methods in the UK: analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline.","volume":"23","author":"Mavranezouli","year":"2008","journal-title":"Hum Reprod"},{"key":"2025121500501487800_R10","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.contraception.2012.07.016","article-title":"Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception.","volume":"87","author":"Trussell","year":"2013","journal-title":"Contraception"},{"key":"2025121500501487800_R11","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.contraception.2013.10.019","article-title":"Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5 mg in contraception.","volume":"89","author":"Trussell","year":"2014","journal-title":"Contraception"},{"key":"2025121500501487800_R12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.contraception.2008.08.003","article-title":"Cost effectiveness of contraceptives in the United States.","volume":"79","author":"Trussell","year":"2009","journal-title":"Contraception"},{"key":"2025121500501487800_R13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S0010-7824(03)00078-7","article-title":"Economic analysis of contraceptives for women.","volume":"68","author":"Chiou","year":"2003","journal-title":"Contraception"},{"key":"2025121500501487800_R14","doi-asserted-by":"publisher","first-page":"209","DOI":"10.2165\/00019053-200017020-00009","article-title":"Economic analysis of long-term reversible contraceptives. Focus on Implanon.","volume":"17","author":"Phillips","year":"2000","journal-title":"Pharmacoeconomics"},{"key":"2025121500501487800_R15","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.contraception.2004.03.008","article-title":"Costs and net health effects of contraceptive methods.","volume":"69","author":"Sonnenberg","year":"2004","journal-title":"Contraception"},{"key":"2025121500501487800_R16","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.contraception.2016.06.016","article-title":"Contraceptive practices among women: the Second Australian Study of Health and Relationships.","volume":"94","author":"Richters","year":"2016","journal-title":"Contraception"},{"key":"2025121500501487800_R17","unstructured":"Livsey A. How much do abortions cost across Australia? \u2013 explainer. 2017. Available at: https:\/\/www.theguardian.com\/news\/datablog\/2017\/aug\/22\/how-much-do-abortions-cost-across-australia-explainer [verified 3 October 2019]."},{"key":"2025121500501487800_R18","doi-asserted-by":"publisher","first-page":"282","DOI":"10.5694\/mja12.10297","article-title":"Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study.","volume":"197","author":"Goldstone","year":"2012","journal-title":"Med J Aust"},{"key":"2025121500501487800_R19","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1007\/s10995-016-2237-0","article-title":"Pregnancy intention and pregnancy outcome: systematic review and meta-analysis.","volume":"21","author":"Hall","year":"2017","journal-title":"Matern Child Health J"},{"key":"2025121500501487800_R20","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1097\/AOG.0b013e31821188ad","article-title":"Continuation and satisfaction of reversible contraception.","volume":"117","author":"Peipert","year":"2011","journal-title":"Obstet Gynecol"},{"key":"2025121500501487800_R21","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3109\/13625187.2013.853034","article-title":"A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.","volume":"19","author":"Weisberg","year":"2014","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025121500501487800_R22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5694\/mja16.00073","article-title":"Uptake of long-acting, reversible contraception in three remote Aboriginal communities: a population-based study.","volume":"205","author":"Griffiths","year":"2016","journal-title":"Med J Aust"},{"key":"2025121500501487800_R23","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1093\/humrep\/dei273","article-title":"A pilot study to assess the effect of three short-term treatments on frequent and\/or prolonged bleeding compared to placebo in women using Implanon.","volume":"21","author":"Weisberg","year":"2006","journal-title":"Hum Reprod"},{"key":"2025121500501487800_R24","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1783\/147118905774480581","article-title":"An assessment of the first 3 years\u2019 use of Implanon in Luton.","volume":"31","author":"Agrawal","year":"2005","journal-title":"J Fam Plann Reprod Health Care"},{"key":"2025121500501487800_R25","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.contraception.2006.05.072","article-title":"Continuation rates of Implanon in the UK: data from an observational study in a clinical setting.","volume":"74","author":"Lakha","year":"2006","journal-title":"Contraception"},{"key":"2025121500501487800_R26","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.contraception.2009.04.003","article-title":"Insertion and 3-year follow-up experience of 372 etonogestrel subdermal contraceptive implants by family physicians in Granada, Spain.","volume":"80","author":"Arribas-Mir","year":"2009","journal-title":"Contraception"},{"key":"2025121500501487800_R27","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0010-7824(00)00140-2","article-title":"Acceptability and performance of the levonorgestrel-releasing intrauterine system (Mirena) in Campinas, Brazil.","volume":"62","author":"Diaz","year":"2000","journal-title":"Contraception"},{"key":"2025121500501487800_R28","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1783\/147118909787931555","article-title":"Actual cost of providing long-acting reversible contraception: a study of Implanon cost.","volume":"35","author":"Lipetz","year":"2009","journal-title":"J Fam Plann Reprod Health Care"},{"key":"2025121500501487800_R29","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1097\/AOG.0b013e3182a91f45","article-title":"Twenty-four-month continuation of reversible contraception.","volume":"122","author":"O\u2019Neil-Callahan","year":"2013","journal-title":"Obstet Gynecol"},{"key":"2025121500501487800_R30","doi-asserted-by":"publisher","first-page":"407","DOI":"10.5694\/mja17.01094","article-title":"Unintended and unwanted pregnancy in Australia: a cross-sectional, national random telephone survey of prevalence and outcomes.","volume":"209","author":"Taft","year":"2018","journal-title":"Med J Aust"},{"key":"2025121500501487800_R31","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1016\/S1701-2163(16)30074-3","article-title":"The cost of unintended pregnancies in Canada: estimating direct cost, role of imperfect adherence, and the potential impact of increased use of long-acting reversible contraceptives.","volume":"37","author":"Black","year":"2015","journal-title":"J Obstet Gynaecol Can"},{"key":"2025121500501487800_R32","doi-asserted-by":"publisher","first-page":"250","DOI":"10.5694\/mja2.50058","article-title":"The Guttmacher\u2013Lancet Commission on sexual and reproductive health and rights: how does Australia measure up?","volume":"210","author":"Bateson","year":"2019","journal-title":"Med J Aust"},{"key":"2025121500501487800_R33","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1111\/ajo.12427","article-title":"Insertion of intrauterine contraceptive devices by registered nurses in Australia.","volume":"56","author":"Kemeny","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025121500501487800_R34","first-page":"710","article-title":"LARCs as first-line contraception: what can general practitioners advise young women?","volume":"46","author":"Temple-Smith","year":"2017","journal-title":"Aust Fam Physician"},{"key":"2025121500501487800_R35","doi-asserted-by":"publisher","first-page":"50.e1","DOI":"10.1016\/j.ajog.2014.07.025","article-title":"Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction.","volume":"212","author":"Diedrich","year":"2015","journal-title":"Am J Obstet Gynecol"}],"container-title":["Australian Health Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/44\/3\/385\/436783\/ah18190.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/44\/3\/385\/436783\/ah18190.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T05:50:17Z","timestamp":1765777817000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/ah\/article\/44\/3\/385\/70299\/Cost-benefit-analysis-of-enhancing-the-uptake-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,28]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6,3]]}},"URL":"https:\/\/doi.org\/10.1071\/ah18190","relation":{},"ISSN":["0156-5788","1449-8944"],"issn-type":[{"value":"0156-5788","type":"print"},{"value":"1449-8944","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,28]]}}}