Abstract：
BACKGROUND:In 2002, the Kaiser Foundation Health Plan in California changed its coverage policy to include 100% universal coverage for the most effective forms of contraception and for emergency contraceptive pills (ECPs). This study sought to evaluate whether removing the cost of contraception as a potential barrier to utilization would lead to a change in the mix of contraceptive methods prescribed and purchased by a large health plan and whether those changes could theoretically result in averting a greater number of unintended pregnancies. STUDY DESIGN:A retrospective observational study was conducted to describe the mix of reversible contraceptives procured before and after the benefit change at Kaiser Permanente Northern California. We then estimated couple-years of protection (CYP) to examine whether the contraceptive mix changed to more effective reversible methods. RESULTS:After the contraceptive benefit change, CYP increased by 28% (from 2001-2002 to 2003-2004), while the number of females aged 15-44 enrolled in this health plan fell by 1%. CYP for intrauterine contraceptives (IUCs) and injectables rose by 137% and 32%, respectively, while CYP for the pill, patch and ring rose only by 16%. The estimated average annual contraceptive failure rate among women using hormonal contraceptives and IUCs declined from 7.0% to 6.4%. Purchasing of the ECP rose by 88%. CONCLUSION:Removal of the cost of contraception may result in increased utilization of more effective methods and ECPs.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Postlethwaite D,Trussell J,Zoolakis A,Shabear R,Petitti Ddoi
10.1016/j.contraception.2007.07.006subject
Has Abstractpub_date
2007-11-01 00:00:00pages
360-5issue
5eissn
0010-7824issn
1879-0518pii
S0010-7824(07)00353-8journal_volume
76pub_type
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