Why a year’s worth of prescription contraceptives needs to be law

contraceptive-pills-849413_640I’m not usually a talk about my reproductive health type person, but something made me so profoundly annoyed I went into a five- minute rant, and hubby was like ”sounds like a blog post”. So here goes:

I’m a very busy woman, and have been become so increasingly in the last few years leading and managing an organization, volunteering in the community, and serving on non-profit boards in my spare time, while maintaining family and friends as I can. I’m not unlike most busy professional women in the DC metro area.

I decided after some conversations with my doctor that I would use the pill for right now. And my doctor always writes a prescription for a year. I put it on mail order pharmacy because I prefer it just come straight to me, so I won’t to forget to jog over to my next door pharmacy (that’s not 24 hours) and get it.

Here’s the catch, the pharmacy only sends me pill packages for three months at a time. And here’s the additional kicker: I have to call it in to receive a refill, it just doesn’t refill automatically.

What did that mean when I had a busy month of travel and I realized I was at the end of three month pill pack with no new packs on its way?

A loud exclamation of: “$%^!”

Frantic calling and several minutes later I reached a pharmacy rep and had the next order refilled and overnighted to me.

The sinking feeling in one’s stomach following by the last minute scramble is a common occurrence for many women all around the nation.

In just about every state except for Oregon & Washington DC, women receive 3 month (or even 1 month) birth control supply from their insurance companies regardless of whether their doctors write a 6 month or 12 month long prescription. And patients, like me, must always call to get the refills.

In a good number of cases when contraception is forgotten or abruptly discontinued without proper restarting, an unwanted pregnancy can result.

According to a 2011 study published in Obstetrics and Gynecology, women who received a year’s supply of birth control pills were 30 percent less likely to have an unplanned pregnancy than those who received either a one-month or three-month supply of pills.

A study conducted by the Centers for Disease Control (CDC) and the World Health Organization (WHO) found that “the more pill packs given, up to 13 cycles, the higher the continuation rates. Restricting the number of pill packs distributed or prescribed can result in unwanted discontinuation of the method and increased risk for pregnancy.”

Indeed research backs this up.

One of the most consistent reasons for an unintended pregnancy is access: According to the Guttmacher Institute to access the most effective methods, a woman must be able to get to a clinic, see a provider, get a prescription and/or make it to follow-up visits. And that of course includes, don’t forget to call the pharmacy every 1-3 months to make sure to refill the pack.

I’m a busy woman, but I have the financial means to overnight my pack from my mail in pharmacy or I (or my husband) can jump in a car if need to find a 24 hour pharmacy.

But what of the countless women in this country who are also busy, working more jobs than me because they have to financially, can’t afford the overnight-a-pack option, don’t have a car, can’t get time off work? It should seem simple to stay on birth control, but sometimes it just isn’t, because reality of life. To note: some (not all) state Medicaid programs (publicly funded health insurance) have 12 month birth control supply options. However, Medicaid is for the poorest of the low income so many folks in great need of quality reproductive health care still aren’t getting it.

Whose policy allows women to only access pills 1-3 months at a time? It’s the policy of private insurance companies.

When American Health Insurance Plans was asked last year why they opposed DC’s bill to provide a 12 month supply of contraceptives. Their spokesperson Clare Krusing said:

“But we do have concerns that an automatic one-year supply of these medications will pose safety and affordability issues for patients, particularly if a woman is picking a brand-name over a generic, for example, or chooses to stop using contraception and is left with potentially months-worth of treatments.”

Safety issues? First there is no drug or intervention that is completely free of risk. Second, that being said, contraception, particularly the oral contraceptive, has long been proven to be one of the safer forms of methods to use. So much so, that the Committee on Gynecologic Practice within the American Congress on Obstetricians & Gynecologists have recommended as early as 2012, a form of oral contraceptive be considered for over the counter usage.

And additionally, doctors/nurses are in the regular habit of scheduling followups 2-3 months after their patient starts taking a new form of contraceptive to screen any particular side effects or issues unique to the patient.

Affordability? Well thanks to Obamacare the majority of private insurance plans have been mandated to provide contraception at no cost to the patient, brand name or generic. Heck most doctors or insurance companies will prescribe you the less expensive option on principle, particularly if a patient requests it.

And then there is this concern that patients will stop using in the midst and have months’ worth of treatments.

One, if a patient stops, let’s assume they generally have a good reason. And two, if they think they might stop in between, why don’t you leave that option for the patient to discuss with their doctor if they want a smaller prescription?!

Methinks at the end of the day, insurance companies care about the profit, and not always about the safety or what is affordable for patients.

Increased access to birth control should be a bipartisan issue that everyone can get behind. According to research compiled by the CDC than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method

Those who want to reduce the number of abortion can argue to their folks this will prevent more unwanted pregnancies resulting in abortion. Those who are family planning advocates will improve contraceptive access for all those who need it.

Nationally in 2015, Congresswomen Jackie Speier and Suzanne Bonamici sent a letter with other Members of Congress signed on that requested the US Department of Health & Human Services to use its existing authority to change the way insurance companies cover birth control prescriptions. This would be a nice easy fix for national regulation so as states wouldn’t individually have to to take it up as legislation, unfortunately there has no movement on it

This year, 2016, at least 13 states have introduced legislation allowing women to access 12 month supply of prescription contraceptives at one time. None have passed thus far.

Find out if your state was one of them and what you can do to help get it passed!

 

 

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