Enhancing access to emergency contraception: Results from a no-cost program in Utah

Area of Science:

• Reproductive Health
• Public Health
• Pharmacology

Background:

• Emergency contraception (EC) access is crucial for reproductive health.
• Cost and provider visit requirements can be significant barriers to EC uptake.
• Two FDA-approved EC methods are available: levonorgestrel and ulipristal acetate.

Purpose of the Study:

• To assess the uptake of no-cost emergency contraception (EC) methods.
• To evaluate patient preference between levonorgestrel and ulipristal acetate.
• To determine the impact of removing cost and access barriers on EC utilization.

Main Methods:

• A study was conducted at University of Utah pharmacies offering levonorgestrel and ulipristal acetate without cost to Utah residents aged 18+.
• Access was facilitated through the MyChart patient portal, bypassing the need for prior provider visits.
• De-identified electronic health record data were analyzed to assess demand, demographics, and method preference.

Main Results:

• A total of 2559 requests were received over two years.
• Ulipristal acetate (57.2%) was preferred over levonorgestrel (42.8%).
• In-person pickups increased, while mail deliveries decreased, indicating growing accessibility.

Conclusions:

• Eliminating cost and provider visit barriers significantly increased EC uptake.
• Patient preference favored ulipristal acetate due to its higher efficacy.
• This model demonstrates a feasible approach for equitable EC access through electronic portals and mail delivery.