Abstract
Eighteen states, including Oregon, have passed legislation requiring insurers to cover dispensation of a 12-month supply of short-acting, hormonal contraception. To determine whether Oregon's 2016 12-month supply law was associated with an increase in contraceptive supply received. This retrospective cohort study of hormonal contraceptive users using Oregon's All Payer All Claims database examined the quantity of contraceptive supply dispensed 3 years before and 3 years after the 2016 policy change. We also assessed changes among patients attributed to Title X clinics. Legislation requiring insurers in Oregon to cover a 12-month supply of contraception to continuing users. Receipt of a 12-month supply of hormonal contraception. This cohort study of insured users (mean [SD] age, 27.4 [2.1] years) of short-acting hormonal contraception included 639 053 contraceptive prescriptions. Results indicated that more than 80% of prescriptions for contraceptives cover 3 months or fewer. Most women in the study population used the oral contraceptive pill, lived in a metropolitan area, and were privately insured. We did not observe a significant association between the passage of the 12-month supply policy and receipt of a 12-month supply (aOR, 1.01; 95% CI, 0.74-1.38). Receipt of a 12-month supply was more common for Medicaid recipients than the privately insured (aOR, 9.40; 95% CI, 6.62-13.34). We did find a shift from 1 month to 2 to 3 months supply being dispensed. The policy change was associated with a small, overall increase in quantity dispensed (0.27 months supply; 95% CI, 0.15 to -0.38). Title X clinics prescribed 3 months more of contraceptive supply than non-Title X clinics (3.03 months supply; 95% CI, 2.64-3.41). However, the policy change was not associated with increased contraceptive supply dispensed at Title X clinics. In this cohort study of insured users of short-acting hormonal contraception, the passage of a 12-month contraceptive supply policy was not associated with an increase in contraceptive supply dispensed.
Highlights
The ability to decide if or when to become pregnant is fundamental to individual rights, health, and people’s role in society.[1]
We did not observe a significant association between the passage of the 12-month supply policy and receipt of a 12-month supply
Receipt of a 12-month supply was more common for Medicaid recipients than the privately insured
Summary
The ability to decide if or when to become pregnant is fundamental to individual rights, health, and people’s role in society.[1] Contraception is a safe and highly effective intervention to prevent pregnancy. In the US, many women rely on the oral contraceptive pill to prevent pregnancy. With perfect use, it has 99% efficacy in preventing pregnancy.[2] breaks in use are common, reducing the effectiveness of oral contraceptives.[2]. Twelve-month prescription policies are an essential step to reduce barriers to contraceptive access.[3] Contraceptive 12-month supply policies require insurers to cover the cost of dispensing a full 12 months of coverage per prescription.[4] In the absence of such policies, clinicians can prescribe a 12-month supply, but insurance coverage typically dictates the amount a person receives.[5] These policies focus on changing insurance company behavior to improve access
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