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Long-acting reversible contraceptive (LARC) methods are birth control methods that provide effective contraception for an extended period of time without requiring user action.

LARC methods
Methods include intrauterine devices (IUD) and subdermal implants: Shorter-acting methods sometimes considered LARC:
 * Hormonal IUD with progestogen (Mirena) - also known as IUC or IUS
 * Nonhormonal IUD with copper (US - Paragard)
 * Subdermal contraceptive implants (US - Implanon; Internationally - Norplant/Jadelle)
 * Depot medroxyprogesterone acetate injection (DMPA; US - Depo Provera shot)
 * Combined injectable contraceptive

Efficacy
The effectiveness of LARC methods has been shown to be superior to other types of birth control. A study in 2012, with the largest cohort of IUD and implant users to date, found that the risk of contraceptive failure for those using oral contraceptive pills, the birth control patch, or the vaginal ring was 20 times higher than the risk for those using LARC methods. For those under 21, who typically have lower adherence to drug regimens, the risk is twice as high.

The discrepancy between LARC methods and other forms of birth control lies in the difference between "perfect use" and "typical use". Perfect use indicates complete adherence to medication schedules and guildelines. Typical use describes effectiveness in real-world conditions, where patients may not fully adhere to medication regimens. LARC methods require little to no user action after insertion; therefore, LARC perfect use failure rates equal those of typical use failure rates. LARC failure rates rival that of sterilization, but unlike sterilization they are reversible. Other reversible methods, such as oral contraceptive pills, the birth control patch, or the vaginal ring require daily, weekly, or monthly action by the user. For those methods, the perfect use failure rate may be similar to that of LARC methods, but the typical use failure rate is significantly higher. Even methods such as the DMPA injection require users to return to their provider every 12 weeks, so typical use failure rates are also higher than perfect use failure rates as more than 40% of women discontinue DMPA in the first year. In both effectiveness and continuation, LARC methods are considered the first-line options for contraception.

Cost
LARC methods traditionally have a higher up-front cost as compared to tother methods such as oral contracptive pills, the patch, and the vaginal ring. However, LARC methods are some of the most cost-effective in the long term. Regardless, the initial cost is still too high for many patients and is one of the biggest barriers to LARC use. Two recent studies done in California and St. Louis have shown that rates of LARC usage are dramatically higher when the costs of the methods are either covered or removed.

Promotion
The United Kingdom Department of Health has actively promoted LARC use since 2008, particularly for young people; following on from the October 2005 National Institute for Health and Clinical Excellence guidelines, which promoted LARC provision in the United Kingdom, accurate and detailed counseling for women about these methods, and training of healthcare professionals to provide these methods. Giving advice on these methods of contraception has been included in the 2009 Quality and Outcomes Framework "good practice" for primary care.

According to other guildines released in 2009 by the American Congress of Obstetricians and Gynecologists, LARC methods are considered to be the first-line option for birth control in the United States, and are reccomended for the majority of women.;