Study: Yearlong birth control supply would cut unintended pregnancies
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Dispensing a year’s supply of birth control pills upfront would reduce the number of unintended pregnancies and health care costs associated with them, according to a new, joint study by University of Pittsburgh’s School of Medicine and the Department of Veterans Affairs.
The researchers estimate offering a year’s supply of pills would prevent 583 unintended pregnancies and save the VA about $2 million a year in prenatal, birth and newborn care costs.
The paper, published Monday in the Journal of the American Medical Association, used a mathematical model to show that if the VA reduced the number of required birth control refills, it would better allow female veterans to prevent undesired pregnancies.
It asserted that the money saved on health care costs would more than outweigh the expense of providing birth control in larger quantities. Veterans would save the out-of-pocket costs of abortions, which is how 42% of veterans’ unintended pregnancies end. Abortions aren’t covered by VA insurance under any circumstances.
“Medication dispensing limits are thought to be cost-saving because you’re not wasting pills and medicines that people aren’t going to use,” said lead author Colleen Judge-Golden, a Ph.D. student at Pitt’s School of Medicine. “Our analysis shows that concerns about wastage of contraceptive pills are overshadowed by the potential consequences of delayed refills, and especially of unintended pregnancies.”
Birth control pills are currently dispensed by the VA in three-month increments. VA data shows that 43% of women receiving a three-month supply of birth control pills experience at least one gap between refills over the course of a year of use. Roughly 24,000 women receive oral contraceptives from the VA.
“We see extended contraceptive dispensing as a win-win, promoting women’s health and women’s autonomy to use birth control as they decide, while also being economically sustainable for the VA,” said Judge-Golden.
Sonya Borrero, a senior author of the study who is director of Pitt’s Center for Women’s Health Research and Innovation and associate director of the VA’s Center for Health Equity Research and Promotion, said there are compelling reasons for considering contraception to be a unique medication.
“Women veterans who use the VA for health care are carrying a huge burden of both medical and mental illness, many of which were incurred during military service, and they also have a high prevalence of sexual trauma history. All of these are exacerbated by the negative impact of having undesired pregnancies,” Borrero said.
To date, 17 states and the District of Columbia have passed laws requiring insurers to cover a year’s supply of contraceptives. Pennsylvania is not one of them.
“This is great opportunity for the VA to roll out this policy change on a national level and continue to be a leader and set an elevated standard for women’s health care,” Borrero said.