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Trends in Prescription Contraceptive Use

Privately insured women had the greatest increase in prescription contraceptive use from 1995 to 2002.

Identifying the factors underlying the U.S. unintended pregnancy rate of almost 50% is essential. In a study designed to evaluate the effect of insurance status on contraceptive use, investigators compared data from two cycles of the National Survey of Family Growth (1995 and 2002; age range of participants, 15–44). During the time between those years, several new contraceptive methods became available; in addition, private insurance coverage of contraceptive agents increased markedly.

From 1995 to 2002, total prescription contraceptive use increased by 3%, but overall nonuse of contraception rose by 4.5%. The increase in prescription contraceptive use was greatest among privately insured women, who were responsible for essentially all the growth: Rates of prescription contraceptive use did not change significantly among publicly insured women and uninsured women. Analysis adjusted for demographic and socioeconomic variables showed that, for both survey years, uninsured women were more than 20% less likely to report using prescription contraceptives than were privately insured women (adjusted relative risk, 0.78; 95% confidence interval, 0.67–0.90).

Comment: These results highlight the key roles played by insurance coverage and direct costs as women make contraceptive choices. That virtually all the increase in prescription contraceptive use occurred among privately insured women makes one wonder whether publicly insured women are aware that contraception often is covered — or is available at low or no cost from various sources (see Table 1).

To counsel patients effectively on contraceptive options, clinicians must be aware of contraceptive costs and coverage. Understanding her own insurance coverage might help guide a patient toward a different (and perhaps more-effective) contraceptive method.

— Ann J. Davis, MD

Published in Journal Watch Women's Health February 14, 2008

Citation(s):

Culwell KR and Feinglass J. Changes in prescription contraceptive use, 1995–2002: The effect of insurance status. Obstet Gynecol 2007 Dec; 110:1371.

• Medline abstract (Free)