Changes in use of hormonal long-acting reversible contraceptive methods in Australia between 2006 and 2018: A population-based study

Background: Long-acting reversible contraceptives (LARCs) are promoted internationally as a key strategy for reducing unintended pregnancy and abortion rates. Aims: To examine trends in use of hormonal LARCs among reproductive-aged women in Australia between 2006 and 2018 and explore trends according to age groups and state/territory of dispensing. Materials and Methods: Retrospective population-based study using Pharmaceutical Benefits Scheme (PBS) dispensing claims of a 10% random sample of females aged 15-44. We investigated rates and annual trends in dispensing claims of etonorgestrel implant and levonorgestrel intrauterine systems (IUS). Results: Between 2006 and 2018, annual PBS claims for LARCs increased approximately two-fold from 21.7 to 41.5 per 1000 women, with a plateau observed from 2015 onward. Absolute rate increases were similar for the implant (9.0/1000) and IUS (10.8/1000), with increases observed across all age groups and states/territories. Overall dispensing rates varied by two-fold according to state/territory of dispensing and four-fold according to age groups. Rate increases for the implant were highest among the 15-19 and 20-24 age groups, while rate increases for the IUS were highest among the 35-39 and 40-44 age groups. It is estimated that in 2018, 10.8% of women aged 15-44 were using a LARC; 4.5% for the implant and 6.3% for the IUS. Conclusions: Rates of hormonal LARC use have doubled over the past decade. Investigating underlying reasons for the large observed differences in rates of use according to age and state/territory could help further improve uptake for these most effective methods of contraception.

Automated summary

The rate of hormonal LARC use among reproductive-aged women in Australia has doubled over the past decade, with variations in usage observed according to age groups and state/territory.