A Zero-Cost Way to Reduce Unintended Pregnancy

Today is World Contraception Day and many are writing about the challenges to birth control access, which are numerous, complex and vary from nation to nation. But researchers have recently identified a simple change that could make a significant difference in preventing unintended pregnancy here in the U.S.

Most U.S. health insurance plans limit the amount of birth control pills that can be prescribed at a time, usually to a three-month supply. A recent study in the journal Obstetrics & Gynecology suggests that prescribing a longer-lasting supply may help women better adhere to their birth control regimen.

In a clinical trial, researchers randomly assigned 661 women of various ages at a New York family planning clinic to receive either three- or seven-month supplies of birth control pills. After six months, 51 percent of women who received the seven-month supply of birth control pills were still taking them, compared to only 35 percent of women who received a three-month supply. The idea that a longer-lasting supply would improve adherence may sound like common sense, but research backing the claim is necessary to convince insurers to change their coverage policies.

The three-month limit was originally intended to make women visit the doctor more frequently thereby increasing the chance that physicians would catch any potential side effects of the pill, like high blood pressure. However, “running out of pills” is one of the most common reasons women cite for going off the Pill, according to Reuters.

Though this particular study did not make the connection explicitly, it stands to reason that giving longer-lasting supplies could translate into a reduction in the number of unintended pregnancies in the US. A different study published earlier this year found that that women in California’s Medi-Cal program given a year’s supply of birth control pills were less likely to have an unplanned pregnancy than those given one-to-three-month supplies.

That makes sense: Running out of pills can cause women miss or skip a day or two or more, which reduces the effectiveness of the Pill in preventing pregnancy. Longer supplies could help the growing numbers of uninsured or underinsured women who can’t cover the cost of a doctor’s visit every three months. They could also provide a safety net for women who unexpectedly lose their jobs and thus their health insurance coverage, and have not budgeted for the full out-of-pocket prescription price (which can be as much as $180 for a three-month supply). In this economy, that is a very real concern.

With funding cuts reducing women’s access to contraception in the U.S. and globally, it’s exciting that simply giving U.S. women longer-lasting supplies of birth control could reduce unwanted pregnancy–at no cost. Let’s hope insurance companies take heed.

Picture from Flickr user Starbooze under Creative Commons 2.0.

Comments

  1. i am all about whatever improves birth control methods. i could not take the pill-ever-so i got fixed early on. never regretted it and no more surprises!

  2. I”m baffled here, where is the logic to a 3 month only prescription ? The reason given for doctor follow up is insufficient, in my opinion.

    Maybe it is from an outside US perspective here, but I’ve never even heard of a woman only being given a prescription for 3 months – it was always 12 months in my experience.

    This is an easy, simple change to make based on logic and common sense.

  3. Rhonda Tuman says:

    Really? It is up to people to remember to reorder their medicine, or if necessary to call their physician’s office. How much responsibility are we expected to relieve people of? Pharmacy’s now have automatic renewal. That was a waste of money study.

  4. @Rhonda Tuman – doctors often refuse to renew over the phone, which means women have to go in to see them for a refill. This can mean missing work, and women in low-wage jobs do NOT have this option. They may even be fired, never mind get their pay docked when they are already living paycheque to paycheque. Only rich, pampered, privileged women can say it isn’t a problem.

  5. In the California study, what was the difference between 3 month and one year prescriptions. If it’s significantly more effective, why would anyone not try the longer time period?

  6. In my experience, you don’t have to get it re-prescribed every 3 months, you just can’t purchase more than 3 months worth at one time over the counter. Generally the doctor will require a visit about as regularly as a yearly physical — an amount of time I see as valid given the dangers of high blood pressure, clotting, or continued pill usage during unplanned pregnancy.

  7. In the end, it comes down to an overall healthcare issue. As someone who is white, low-income from a middle-class family, who has a college degree and collecting unemployment, I have been without health insurance for quite some time; and without health insurance and being low-income, everything requires a big more thought. It comes down to does the money for the week go to gas in the car or food; do I have enough for both?

    I also think it’s difficult to talk about contraception and only focus on one form when there are many others, including the obvious one where prescriptions aren’t necessary: condoms. I wrote my response in my blog post today http://shapedbymylife.blogspot.com/2011/09/world-

  8. I personally have to re-visit my doctor every three months for a new refill.

    I think a far better solution would be to give a year-long prescription with the condition that the patient receive a PAP test every year when she gets her refill. This actually kills two birds with one stone, as getting a PAP test is something many women don’t do frequently enough.

  9. I live in New Zealand, and we get prescribed our oral contraceptives for a three-month trial to see if that pill suits us, then after that we get a six-month supply. A lot of our pills are subsidised (as far as I know), and I think it’s something like $3 for the six-month supply for one of the types they start you on. I pay $40 for my six-month supply because I had to switch to lower-oestrogen pills, but I think my friends are paying $3 for theirs.

    Having a longer supply definitely would keep more women on, because often it’s quite difficult and expensive to get to the doctor every few months.

  10. Very good points. Also, it is always a challenge to get in to see my doctor, and being a busy college student I often call last minute adding to the stress of getting in before I run out. Planned Parenthood supplies a year supply of pills at a time, it is so much easier than the way my insurance company does it.

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