The restricted PBS listing for levonorgestrel-releasing intrauterine device (Mirena) was extended on 1 August 2007 to include women in whom oral therapies for idiopathic menorrhagia are ineffective or contraindicated.1 This device was previously restricted for contraceptive use only.
The PBAC recommended extending the listing based on cost-minimisation compared with hysterectomy. Treatment with a levonorgestrel-releasing intrauterine device may not be a lasting alternative to hysterectomy for menorrhagia.2 However, it offers women a more conservative option that will allow them to become pregnant on removal of the device.
- Australian Government Department of Health and Ageing PBB. March 2007 PBAC Outcomes — Positive Recommendations. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/pbacrec-mar07-positive#lev (accessed 18 May 2007).
- Hurskainen R, Teperi J, Rissanen P, et al. Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: Randomized trial 5-year follow-up. JAMA 2004;291:1456-63.