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Does a Low Cost for Clinics Mean More Underinsured Patients Are Able to Choose a Hormonal IUD? One Study in Utah Sought to Find Out

At the beginning of this year, an estimated 7.7 million women of reproductive age (15-44) in the United States were uninsured, with 2 million of these women living below the federal poverty level. As the ongoing novel coronavirus pandemic has led to historic numbers of unemployment claims, it is estimated that millions more have lost their employer-provided health insurance. More uninsured people mean more people paying out of their own pockets for birth control, which can be prohibitively expensive.  In the case of long-acting reversible contraceptive (LARC) methods, such as the hormonal intrauterine device (IUD), out of pocket costs can exceed $1,000.

At Medicines360, our mission is to remove cost as a barrier to health by developing and providing affordable women’s health products.  Our ongoing impact measurement initiatives seek to understand to what extent the price of hormonal IUDs impacts a clinic’s ability to offer LARCs to low-income patients, particularly the uninsured or underinsured. We especially want to know whether more patients who desire a hormonal IUD are able to obtain one.

A team led by David Turok and Lauryn Roth at the University of Utah independently studied how the introduction of a low-cost IUD affected uptake of LARC methods. The team retrospectively reviewed electronic medical records from seven family planning clinics in Utah that received federal funds to support family planning access for underserved women (known as Title X grants).

The research team compared uptake of hormonal IUDs and other LARCs before and after the clinics began offering a low-cost IUD in May 2015. Significantly more patients received a hormonal IUD after the introduction of a low-cost product. Insertions of hormonal IUDs increased from approximately 29 per month at the outset of the study period to approximately 43 in the first month after a low-cost product was introduced. There continued to be a steady increase over the following 11 months.

Patients in these clinics also started using other LARCs, such as contraceptive implants and copper IUDs, significantly more in the 11 months after a low-cost product was introduced compared to pre-introduction. Preference for and uptake of use of products in this category may have been influenced by external factors that could not be accounted for including, but not limited to, increased awareness of LARC methods in the community.

The results of this study contribute evidence to our hypothesis that by reducing costs of LARC devices, women may have greater contraceptive access and ability to select a LARC device if desired.  At a time when so many people are likely losing employer-sponsored insurance, Medicines360 is committed to its mission to ensure cost does not stand between a woman and her access to medicines. 

To read more about it, access the full article from the July 2018 issue of Contraception here.

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