Universal Access to Contraception

Ottawa – Mark Holland, Minister of Health, announced the Government of Canada’s next step toward national universal pharmacare with the introduction of Bill C-64, An Act respecting pharmacare, into Parliament, and the intention to provide universal, single-payer coverage for a range of contraception medications and devices in collaboration with provinces and territories (PTs).

Contraceptives

Contraception, also known as birth control, is used to prevent pregnancy. In Canada, there are more than 9 million people of reproductive age, nearly one quarter of the Canadian population.

Contraceptive drugs were chosen as part of this next step of universal pharmacare specifically because improved access to contraception improves equality. It reduces the risk of unintended pregnancies and improves reproductive rights.

Cost has been identified by Canadian contraceptive care providers as the single most important barrier to access to these medications. Oral contraceptives cost approximately $25 per unit, or $300 per year. Intrauterine Devices (IUDs), which are effective for five years, cost approximately up to $500 per unit.

Cost can discourage people both from accessing contraception, and from choosing more effective methods of contraception with a higher upfront cost. For example, oral contraceptives have a typical use failure rate of 9% compared to 0.20% for IUDs. Not having affordable access to effective contraception can increase the risk of unintended pregnancies, which can impact life plans such as going to school and advancing in one’s career.

Some populations are disproportionally affected by the lack of coverage. Women, people with low incomes and young people, all of whom are all more likely to work in part-time or contract positions, often lack access to private coverage. One study found that women and girls from lower-income households are more likely to use less-effective contraceptive methods or no contraceptive method.

Although most drug plans list a range of contraceptive products, only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan. If they do not have drug coverage through an employment-based private health benefit plan, Canadians would typically have access to only a public safety net coverage plan intended to protect residents from very high drug costs. The high deductibles under these plans (e.g., 3-20% of household income), in addition to co-payments, mean these plans typically offer little relief for routine drug expenses, such as contraception.

Studies have demonstrated that publicly funded no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia (BC) estimated that no-cost contraception has the potential to save the BC health care system approximately $27 million per year.

Types of Contraceptives Being Covered

Today’s announcement will ensure that, following agreement with PTs, people in Canada will have access to a comprehensive suite of contraceptive drugs and devices to choose from according to their medical suitability and personal circumstances. This includes oral contraceptives, copper and hormonal IUDs, injections, implants, rings, and morning-after pills. The Government of Canada will be launching discussions with PTs on providing universal, single-payer coverage based on the list of contraceptive drugs and devices attached to this backgrounder.