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Clinically Speaking: Addressing Contraceptive Care Needs

There are steps plan sponsors can take to address reproductive health care needs, beginning with contraceptive care.

Reproductive health is integral to an individual’s overall health, and access to reproductive health care and education is essential for physical and mental well-being.

Contraceptive care basics 

Contraception use is highly personal. Many factors go into the decision to use birth control and what type, such as access, convenience, cost, religious beliefs, risks, and side effects.

Contraceptives can be used for more than pregnancy prevention. They can reduce the risk of endometrial and ovarian cancer, and may be used in the treatment of hormone-related migraines. In addition they may be prescribed to control the symptoms of severe bleeding and pain associated with menstrual periods. 

Medications and forms of birth control include short-acting hormonal methods, long-acting reversible contraceptives, contraceptive injection, barrier methods, and permanent sterilization. Currently, condoms are the only male method of birth control besides vasectomy

Among females age 18 to 64, including those who identify as women and other genders, 90% have used contraception at some point in their reproductive years. And 76% have used more than one birth control method in their lifetime. Our own pharmacy claims data shows that contraceptives are among the highest utilized prescription drugs for members 25 to 35 years old.

Contraceptive care barriers

While unintended pregnancies are at an all-time low in the U.S., they still represent about 45% of all pregnancies. Unplanned pregnancy is associated with increased risk for mom and baby and may result in delayed prenatal care. On the other hand, women with planned pregnancies tend to engage in behaviors that promote a healthy pregnancy, including folic acid intake, and cessation from alcohol, tobacco, recreational and some prescribed drugs.

Access and affordability are two critical factors for consistent use of birth control. Studies show that nearly 1 in 5 females do not use their preferred method of contraception. Of those who were not adherent, 25% cited they could not afford their preferred contraceptive.

Health inequities tied to race, social, geographic, and economic factors can significantly impact access to safe, effective and affordable birth control options. More than 19 million women live in “contraception deserts” in the U.S. today, and Hispanic and black women have the highest rates of unintended pregnancy.

Action steps to provide access to contraceptive care

There are five ways plan sponsors can support access to birth control and contraceptive care:

  1. Ensure affordability by offering a zero dollar copay.
  2. Enable flexibility and support for contraceptives, similar to other ongoing medications. For example, allow for convenient delivery straight to a member’s home, work, or school. And give patients 24/7 access to pharmacists with experience and training who counsel patients on the safe and effective use of their medication.
  3. Improve adherence and convenience by offering a 90-day supply. Nearly one third of hormonal contraceptive users have missed their medication because they weren’t able to get their next supply.
  4. Provide up-to-date educational resources, which can help members make informed decisions and use contraception more effectively.
  5. Drive member engagement with digital tools and point-of-care connections with health care providers and pharmacies.

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FamilyPath
FamilyPath has expanded benefit offerings across family-planning, fertility, pregnancy and postpartum care for employers and health plans. Evernorth is committed to addressing disparities in this category of health benefits and has designed an end-to-end, inclusive benefit in family-planning care for members across both in-house capabilities and new partnership solutions.