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Out-of-pocket costs and inconvenient monthly pharmacy visits may be barriers to women's consistent use of oral contraceptives

Uninterrupted use of oral contraceptive pills (OCPs) is necessary for optimal effectiveness. However, out-of-pocket costs for OCPs and the inconvenience of making monthly pharmacy visits may be barriers to women's consistent use of OCPs, suggests a study supported in part by the Agency for Healthcare Research and Quality (HS10771 and HS10856). The researchers found that privately insured women paid, on average, 60 percent of the total expenditures for OCPs, which cost about $14 per monthly pack, and 73 percent obtained only one pack per purchase.

Women who had no prescription drug coverage, were uninsured, or were privately insured but not in managed care plans had higher out-of-pocket expenditures for oral contraceptives. Also, women who were in managed care plans or did not have prescription drug coverage were more likely to obtain only one pack of OCPs per purchase, despite clinical recommendations that women obtain three packs per visit. Insurer restrictions often limit purchases at community pharmacies to a 30-day supply. Yet, these dispensing limits may have important consequences for consistent use of any chronic medication, cautions lead investigator Kathryn A. Phillips, Ph.D., of the University of California, San Francisco.

Dr. Phillips and her colleagues suggest several interventions that would help ensure full access to contraceptives. These include increased insurance coverage of contraceptives; increased access to generic or lower cost OCPs, particularly for uninsured women; and increased use of mail order prescription services that allow purchase of a 90-day supply of medication. Study findings are based on an analysis of data from AHRQ's 1996 Medical Expenditure Panel Survey of health status, health care use and expenditures, and other related characteristics of the noninstitutionalized U.S. civilian population.

See "Out-of-pocket expenditures for oral contraceptives and number of packs per purchase," by Dr. Phillips, Naomi E. Stotland, M.D., Su-Ying Liang, Ph.D., and others, in the Journal of the American Medical Women's Association 59, pp. 36-42, 2004.

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