The Relationship Between Prescription Copayments and Contraceptive Adherence in a New-user Cohort

Medical Care
Cassondra MarshallTina Raine-Bennett

Abstract

Contraceptive nonadherence is an important contributor to unintended pregnancy in the United States. While the elimination of patient cost sharing has been cited as means to improve contraceptive access, little is known about the relationship between cost sharing and ongoing adherence and continuation of chosen methods. The purpose of this study was to examine the relationship between copayment amount and adherence to pharmacy-dispensed contraception in young women. We conducted a retrospective cohort study of 39,142 women ages 19-29 with a new prescription for the contraceptive pill, patch, or ring at Kaiser Permanente Northern California during 2011-2014. We examined 12-month nonadherence as measured by timely prescription refills and used multivariable Cox proportional hazards models to assess the association between copayment amount and the risk of nonadherence. Ninety-four percent of women used the pill, and 6% used the patch or ring. Forty percent of patients had no copayment and 25% had a copayment of ≥$30. Nearly 75% of women were nonadherent during the study period. In 2013 and 2014, women with a copayment had a 9% increased risk of nonadherence (adjusted hazard ratio, 1.09; 95% confidence interval, 1.04, 1.14) compare...Continue Reading

References

Oct 3, 1998·American Journal of Obstetrics and Gynecology·M J Rosenberg, M S Waugh
Jun 26, 2008·Perspectives on Sexual and Reproductive Health·Jennifer J Frost, Jacqueline E Darroch
Jun 15, 2010·American Journal of Obstetrics and Gynecology·Gina M SecuraJeffrey F Peipert
Mar 15, 2011·Contraception·Meredith E PittmanJeffrey F Peipert
Nov 15, 2011·Contraception·Aileen M GariepyEleanor B Schwarz
Jan 25, 2013·Obstetrics and Gynecology·Jourdan E StuartJeffrey F Peipert
Feb 19, 2014·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Rashid KazerooniAnthony P Morreale
Apr 11, 2015·Contraception·Jourdan E TriebwasserJeffrey F Peipert
Mar 11, 2016·The New England Journal of Medicine·Lawrence B Finer, Mia R Zolna

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Methods Mentioned

BETA
contraception
hysterectomy

Software Mentioned

SAS

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