Potential public sector cost-savings from over-the-counter access to oral contraceptives

Contraception
Diana Greene FosterDaniel Grossman

Abstract

This study estimates how making oral contraceptive pills (OCPs) available without a prescription may affect contraceptive use, unintended pregnancies and associated contraceptive and pregnancy costs among low-income women. Based on published figures, we estimate two scenarios [low over-the-counter (OTC) use and high OTC use] of the proportion of low-income women likely to switch to an OTC pill and predict adoption of OCPs according to the out-of-pocket costs per pill pack. We then estimate cost-savings of each scenario by comparing the total public sector cost of providing OCPs OTC and medical care for unintended pregnancy. Twenty-one percent of low-income women at risk for unintended pregnancy are very likely to use OCPs if they were available without a prescription. Women's use of OTC OCPs varies widely by the out-of-pocket pill pack cost. In a scenario assuming no out-of-pocket costs for the over-the counter pill, an additional 11-21% of low-income women will use the pill, resulting in a 20-36% decrease in the number of women using no method or a method less effective than the pill, and a 7-25% decrease in the number of unintended pregnancies, depending on the level of use and any effect on contraceptive failure rates. If ou...Continue Reading

References

Apr 22, 2006·Contraception·Solmaz ShotorbaniJacqueline Gardner
Sep 2, 2008·Obstetrics and Gynecology·Daniel GrossmanJoseph E Potter
Apr 30, 2009·Health Affairs·Stephen ZuckermanKaren E Stockley
Feb 24, 2011·Obstetrics and Gynecology·Joseph E PotterDaniel Grossman
Apr 12, 2011·Contraception·James Trussell
Oct 18, 2011·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Diana Greene FosterDaniel Grossman
Oct 25, 2011·Contraception·Lawrence B Finer, Mia R Zolna
May 5, 2012·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·M Antonia BiggsDiana Greene Foster
Jun 12, 2012·Perspectives on Sexual and Reproductive Health·Amanda Dennis, Daniel Grossman
Jul 3, 2013·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Diana Greene FosterClaire D Brindis
Dec 21, 2013·American Journal of Public Health·Lawrence B Finer, Mia R Zolna

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Citations

Oct 18, 2015·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Sarah BaumDaniel Grossman
Jun 23, 2015·Perspectives on Sexual and Reproductive Health·Ruth Manski, Melissa Kottke
Nov 26, 2015·Obstetrics and Gynecology Clinics of North America·Daniel Grossman
Jul 17, 2016·Contraception·Erin N Berry-BibeeKathryn M Curtis
Sep 25, 2016·Reproductive Health·Pilar Carrasco-GarridoRodrigo Jiménez-García
Apr 2, 2019·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Stephanie NieuwinckelHans De Loof
Sep 18, 2020·Journal of Midwifery & Women's Health·Amy Alspaugh
Jul 14, 2019·Journal of the American Pharmacists Association : JAPhA·Casey R TakKaren M Gunning
Mar 22, 2021·Health Economics Review·Annesha WhiteMarc Fleming

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