Free contraceptives lead to substantial economic benefits
Improving access to contraception is one of the best means of increasing its use, thereby reducing the risk of unintended pregnancy
ON April 1, British Columbia announced a new policy to provide free prescription contraception for all residents. Discussions surrounding Alberta’s stance have followed. While B.C. is the first Canadian province to adopt free contraception, it is not the first globally. More than 25 countries worldwide, including the United Kingdom, New Zealand and Australia, have offered subsidized or free contraception since as far back as 1967. As resident physicians in obstetrics and gynaecology, we know that universal access to contraception not only benefits patients but also has substantial economic benefits.
On a broader economic scale, free contraception saves taxpayer dollars. B.c.-based Options for Sexual Health estimates that for every $1 spent on contraceptive support for an individual, taxpayers may save up to $90 in future social support. In Canada, up to 40 per cent of pregnancies are unintended and more than half of these unintended pregnancies occur in people not using contraception. The direct cost associated with unintended pregnancies per year in Canada is upwards of $320 million.
Improving access to contraception is one of the best means of increasing its use, thereby reducing the risk of unintended pregnancy. Comparatively, a recent news article quoted a cost of only $30 million in health-care dollars to make contraception free for all Alberta residents, representing less than 0.05 per cent of Alberta’s overall health-care budget.
On an individual level, it is well known that not all forms of contraception are equivalent. The most effective forms of contraception are often the most initially cost-prohibitive for patients ($300 to $500 for an intrauterine device, or IUD), even if that results in longer-term savings. Cost is a major barrier to contraception, and when barriers of cost, access and knowledge are removed, people often no longer choose the cheapest options but instead choose the most effective and least user-dependent methods (i.e. IUD or implant).
By providing free contraception, the individual lifetime projected savings are up to $10,000. Furthermore, this policy would also promote equality by eliminating the financial burden that disproportionately falls on women.
Additionally, many contraceptive options offer more than just pregnancy prevention but are also some of the most effective treatments for many gynaecologic conditions. When adequately treated, patients experience improvement in their quality of life, treatment for chronic conditions (endometriosis, cyclic pain syndromes, chronic anaemia) and risk reduction for various types of cancer (ovarian and endometrial). This translates into fewer days of missed work, improved productivity, and less reliance on more invasive and expensive treatments such as surgery. Treatment of these conditions therefore not only improves medical outcomes, but also offers economic benefits for the patient, their families and society.
As resident doctors in gynaecology, we carry the stories of our patients. We strongly believe in these life-changing therapies as we have seen the tremendous impact of untreated gynaecological conditions and unplanned pregnancies on our patients’ lives. We believe it is our responsibility to advocate for universal access to all forms of contraception so that our patients can choose whichever method is best for them. Cost should not be a barrier to any medical treatment.
We have witnessed the role that safe and effective contraception can play in patients’ lives and are hopeful for the day when all Albertans have equal access. We believe that access to universal contraception is not only a reproductive right, but a basic human right.
We urge Albertans to voice their support for free prescription contraception; we commend the NDP for their commitment to providing free contraception to all residents of Alberta; and we call on the UCP to make the same commitment.