Contraceptive implant will be offered by SUS later this year, says minister

The Unified Health System (SUS) will start offering the contraceptive hormonal implant, known as Implanon, free of charge. The incorporation of the method was approved this Wednesday, the 2nd, by the National Commission for the Incorporation of Technologies in the SUS (Conitec) and the expectation is to make 500 thousand devices available this year, according to the Minister of Health, Alexandre Padilha.

The implant, which can cost up to R$4,000 to apply in the private sector (R$1,000 for the device and R$3,000 for the application), will be an option for adult women aged 18 to 49, who currently only have the copper IUD as a long-term reversible contraceptive.

Today, Implanon is made available by the SUS only for specific groups, such as women living with HIV/AIDS and using the medication dolutegravir, patients using thalidomide or undergoing tuberculosis treatment with aminoglycosides, as well as women deprived of liberty and sex workers.

The Ministry of Health is expected to publish the ordinance that makes the incorporation of the contraceptive official in the coming days. From the publication date, technical areas have 180 days to make the offer effective, which involves steps such as updating clinical guidelines, purchasing and distributing the input, and training professionals.

Contraception and public health policies

Gynecologist Ilza Maria Urbano Monteiro, president of the National Specialized Commission on Contraception of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), highlights that the entity celebrates the news.

As the doctor explains, the greater the availability of contraceptive methods, the greater the chance of achieving adequate adherence. “It increases contraceptive coverage because there will always be a method that best suits each woman’s needs.”

Implanon is classified as a long-acting, highly effective reversible method (LARC), like the copper IUD and the hormonal IUD. “These methods are considered more effective in reproductive planning because they do not depend on continuous or correct use by the user, as is the case with oral or injectable contraceptives,” the ministry highlights in a note.

The ministry also emphasizes that, in addition to preventing unplanned pregnancies, access to contraceptives contributes to reducing maternal mortality, in line with the United Nations (UN) Sustainable Development Goals (SDGs). Brazil's goal is to reduce overall maternal mortality by 25% and by 50% among black women by 2027.

According to Ilza, the challenge now is to make the implant available to all women. “This will depend on the structure of the SUS, which we hope will become increasingly organized. This is our chance to spread this method nationwide.”

The method

The subdermal implant is a small rod, approximately 3 cm long and 2 mm in diameter, containing etonogestrel, a synthetic hormone that blocks ovulation.

The device is inserted into the woman's arm during a consultation, under local anesthesia. Its mechanism of action involves two pathways: it prevents ovulation and thickens the mucus in the cervix, which makes it difficult for sperm to pass through.

Each rod lasts up to three years, without the need for interventions during this period. After this time, the implant must be removed and, if desired, a new one can be inserted during the same consultation. Fertility returns quickly after removal.

Ilza emphasizes that the method is safe and highly effective – the failure rate is around 5 in every 10 thousand women. However, it does not offer protection against sexually transmitted infections (STIs), which only condoms do.

The doctor also reminds us that contraceptive implants should not be confused with hormonal implants that contain anabolic steroids or androgenic hormones, often used for aesthetic purposes and called “beauty chips”, which are prohibited by the National Health Surveillance Agency (Anvisa).