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Contraception. 2016 May;93(5):392-7. doi: 10.1016/j.contraception.2016.01.008. Epub 2016 Jan 21.

Are women benefiting from the Affordable Care Act? A real-world evaluation of the impact of the Affordable Care Act on out-of-pocket costs for contraceptives.

Author information

1
Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA. Electronic address: amy.law@bayer.com.
2
Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
3
Novosys Health, Green Brook, NJ, USA.
4
Wharton School of Business, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA.

Abstract

OBJECTIVES:

The Affordable Care Act (ACA) mandated that, starting between August 1, 2012 and July 31, 2013, health plans cover most Food and Drug Administration (FDA)-approved contraceptive methods for women without cost sharing. This study examined the impact of the ACA on out-of-pocket expenses for contraceptives.

STUDY DESIGN:

Women (ages 15-44years) with claims for any contraceptives in years 2011, 2012 and 2013 were identified from the MarketScan Commercial database. The proportions of women using contraceptives [including permanent contraceptives (PCs) and non-PCs: oral contraceptives (OCs), injectables, patches, rings, implants and intrauterine devices (IUDs)] in study years were determined, as well as changes in out-of-pocket expenses for contraceptives during 2011-2013. Demographics, including age, U.S. geographic region of residence and health plan type, were also evaluated.

RESULTS:

The number of women identified with any contraceptive usage in 2011 was 2,447,316 (mean age: 27.6years), in 2012 was 2,515,296 (mean age: 27.4years) and in 2013 was 2,243,253 (mean age: 27.4years). In 2011, 2012 and 2013, the proportions of women with any contraceptive usage were 26.3%, 26.2% and 26.9%, respectively. Over the three study years, mean total out-of-pocket expenses for PCs and non-PCs decreased from $298 to $82 and from $94 to $30, respectively. For non-PCs, mean total out-of-pocket expenses for OCs and IUDs decreased from $86 to $26 and from $83 to $20.

CONCLUSIONS:

Implementation of the ACA has saved women a substantial amount in out-of-pocket expenses for contraceptives.

IMPLICATIONS:

Mean total out-of-pocket expenses for FDA-approved contraceptives decreased approximately 70% from 2011 to 2013. Implementation of the ACA has saved women a substantial amount in out-of-pocket expenses for contraceptives. Longer-term studies, including clinical outcomes, are warranted.

KEYWORDS:

Affordable Care Act; Contraceptives; Cost-savings; Out-of-pocket expenses

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