Universal Free Contraception Coverage Policy, Out-of-Pocket Payments, and Costs

How did out-of-pocket patient costs and payer type for contraceptives change after implementation of a universal, first-dollar contraceptive coverage policy in British Columbia, Canada?In this controlled interrupted time-series analysis of aggregate monthly data for nearly 2.8 million contraceptive prescriptions, the policy was consistent with a significant decrease in the out-of-pocket share of expenditures, from 38.7% to 9.6% after 2 years (by CAD $8 per capita), with the largest change among individuals aged 20 to 29 years (CAD $11 per capita), who had the highest prepolicy costs.When universal (single-payer), first-dollar contraceptive coverage was introduced, patients’ out-of-pocket costs were substantially reduced, particularly in young adults who had high prepolicy out-of-pocket costs, underscoring the value of universal coverage mandates for contraceptives.

Corresponding Author: Elizabeth Nethery, PhD, Faculty of Pharmaceutical Sciences, University of British Columbia, 2450 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 1Z3 (elizabeth.nethery@ubc.ca).

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