Over-the-Counter Emergency Contraception Could Save Insurers Money
Allowing women to access emergency contraception without a prescription could save private insurance companies more than $100 and government providers nearly $50 per enrollee, according to a study published in the September issue of the American Journal of Public Health. Kristin Marciante and colleagues from the pharmacy department at the University of Washington-Seattle measured the cost of requiring women to access EC from a physician or clinic compared to the cost of allowing women to directly access the Yuzpe regimen of EC, which contains a combination of estrogen and progestin. Emergency contraceptives can prevent pregnancy if taken within 72 hours of having unprotected sex. The study was conducted in 1997 in Washington state, the only state in the country that allows EC to be dispensed without a doctor's prescription. The study states that 49% of pregnancies are unintended and 48% of women ages 15 to 44 report having "at least" one unintended pregnancy during their lifetime. Researchers found that 4.9% of women who did not receive EC from a pharmacy became pregnant, compared to 1.8% of women who accessed EC through a pharmacy. The study found that allowing over-the-counter access to EC resulted in a savings of $158 per woman for private insurers and a savings of $48 per woman for public insurance programs.
The study authors stated that the design of the study posed some limitations. Progestin-only EC pills were not available during the pilot project, and new studies have shown that the effectiveness of the Yuzpe regimen is lower than previously thought. Incorporating new findings on the Yuzpe method's effectiveness, the authors conclude that the savings would amount to $119 per woman for private insurers and $32 per woman for public coverage. However, if the more effective progestin-only EC were used, the cost savings of over-the-counter access to EC would be $179 per woman for private plans and $57 per woman for public coverage. The researchers state that allowing over-the-counter access to EC reduces the risk of unintended pregnancies and saves money for public and private insurance providers. They add that pharmacists have "drug expertise" and are qualified to prescribe EC to "expand the network of contraceptive resources" (Marciante et al., American Journal of Public Health, September 2001).