| Summary: | The CADTH reanalysis showed that etonogestrel is expected to cost $7 more but yield 0.006 fewer quality-adjusted life-year (QALY) losses than the copper intrauterine device (IUD), leading to an incremental cost-effectiveness ratio (ICER) of $1,251 per QALY. It was shown to be at least as effective and less costly than all other contraceptive options considered. The model lacked robust evidence for key aspects which limited CADTH's ability to derive a reliable base-case estimate. Instead, in CADTH reanalyses, key parameters, such as efficacy, are based on assumptions. From a cost perspective, the annual cost of using etonogestrel is less expensive than most forms of contraception, except for copper IUDs and intrauterine systems (IUSs) if used for the full three years. The lack of comparative evidence is the main limiting factor as the efficacy and adverse event (AE) profiles of the different contraceptive methods have not been addressed in any way using direct or indirect methods. Although etonogestrel appears economically attractive, this result is grounded in assumptions of comparative effectiveness with other contraceptive methods, mainly IUSs. If it is believed that etonogestrel is as effective and safe as other contraceptive alternatives, then it represents a cost-effective use of health care resources
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