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Cost Effectiveness of Introducing Etonorgestrel Contraceptive Implant into India’s Current Family Welfare Programme

Author

Listed:
  • Beena Joshi

    (National Institute for Research in Reproductive Health)

  • Kusum V. Moray

    (National Institute for Research in Reproductive Health)

  • Oshima Sachin

    (Ministry of Health and Family Welfare)

  • Himanshu Chaurasia

    (National Institute for Research in Reproductive Health)

  • Shahina Begum

    (National Institute for Research in Reproductive Health)

Abstract

Objectives The aim of this study was to provide evidence to policy makers on cost effectiveness and budget impact for the introduction of the etonorgestrel implant into the Indian public health system. Methods An economic evaluation was conducted to ascertain the potential costs and outcomes of adding the etonorgestrel implant to the public health system of India as compared to the current scenario. A decision analytical model (Markov cohort) was conceptualized from a societal perspective, where a hypothetical population of 15-year-old females was followed until menopause. The primary outcome was incremental cost-utility ratio (ICUR). Sources for model inputs included country-level secondary data analysis, government reports, an observational primary costing study, a systematic review of etonorgestrel implant and targeted literature reviews. One-way and probabilistic sensitivity analyses (OWSA and PSA) were performed to account for uncertainty. The impact of etonorgestrel implant introduction on the annual Indian health budget was also analysed. Results The base-case ICUR was 16,475 Indian rupees (INR) (USD 232) per quality-adjusted life-year gained, which showed the etonorgestrel implant to be very cost effective (ICUR below willingness-to-pay threshold of INR 137,945 [USD 1943]). OWSA showed that discount rate, percentage of people who do not use contraceptives and costs of managing side effects were the important parameters that affected ICUR. PSA showed that ICUR values of all 1000 Monte Carlo simulations were cost effective. Budget impact analysis showed that introduction of the implant would account for

Suggested Citation

  • Beena Joshi & Kusum V. Moray & Oshima Sachin & Himanshu Chaurasia & Shahina Begum, 2021. "Cost Effectiveness of Introducing Etonorgestrel Contraceptive Implant into India’s Current Family Welfare Programme," Applied Health Economics and Health Policy, Springer, vol. 19(2), pages 267-277, March.
    • Handle: RePEc:spr:aphecp:v:19:y:2021:i:2:d:10.1007_s40258-020-00605-5
    DOI: 10.1007/s40258-020-00605-5
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Journal round-up: Applied Health Economics and Health Policy 19(2)
      by karanshahk2 in The Academic Health Economists' Blog on 2021-04-19 06:00:07

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