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A real-world assessment of out-of-pocket contraceptive costs before and after the implementation of the Affordable Care Act in the U.S
Methods: Women (15-44 years) with claims for any contraceptive in years 2011, 2012, and 2013 were identified from the MarketScan Commercial Claims database. The number and proportions of women using contraceptives, including oral contraceptives (OCs), injectables, patches, rings, implants, and intrauterine devices (IUDs), in study years were determined, as well as changes in total out-of-pocket expenses for contraceptives between years 2011 and 2013. Using U.S. Census data, the default findings were projected to the national level.
Results: The number of women identified with any contraceptive usage was 2,410,778 (mean age: 27.5 years) in 2011, 2,479,219 (mean age: 27.4 years) in 2012, and 2,211,990 (mean age: 27.3 years) in 2013. The proportions of women with contraceptive usage in years 2011, 2012, and 2013 were 25.87%, 25.83%, and 26.49%, respectively. Mean total out-of-pocket expenses for any contraceptives decreased from $94 to $30 during 2011 to 2013, respectively. Based on U.S. Census data, it was estimated that for the entire population of women in the U.S., the total out-of-pocket expenses for contraceptives declined nearly 70%, from $261,225,616 in year 2011 to $81,489,725 in year 2013.
Conclusions: The contraceptive coverage provision of the ACA has benefited women in the U.S. with a substantial reduction in out-of-pocket expenses for contraceptives.
Learning Areas:
Biostatistics, economicsProvision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Learning Objectives:
Assess whether the implementation of the ACA has led to changes in out-of-pocket expenses for contraceptives.
Keyword(s): Affordable Care Act, Contraception
Qualified on the content I am responsible for because: I was one of the lead researchers who had conceptualized the study. My work is focused on health economics and health outcomes assessments of medical interventions, primarily in the area of Womenâs Health. I also had prior experience in rheumatology and anemia of chronic kidney disease.
Any relevant financial relationships? Yes
| Name of Organization | Clinical/Research Area | Type of relationship |
|---|---|---|
| Bayer | Health Economics | Employment (includes retainer) |
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.