Impact of the COVID-19 Pandemic on Contraceptive Utilization and Costs in the United States: An Interrupted Time...

We aimed to characterize the trends in contraceptive utilization rates and unit costs of contraceptive prescriptions, and to evaluate the impact of the COVID-19 pandemic on contraceptive utilization and costs.

We conducted an interrupted time series analysis using the IQVIA PharMetrics® Plus for Academics database from 2018 to 2022. We identified female enrollees aged 15-44 years with pharmacy coverage to estimate their monthly contraceptive utilization rate (number of contraception pharmacy claims per 100,000 female enrollees) and unit cost of contraceptive prescription (cost per prescription). Autoregressive integrated moving average models were used to analyze the time series data. The model estimated forecasted outcomes and impact parameters, including level changes and slope changes, to assess the impact of the COVID-19 pandemic.

We identified 896,761 and 696,409 individuals during the prepandemic and pandemic periods. Implants and intrauterine devices had a significant drop in monthly utilization rates immediately after the onset of the pandemic, with decreases of 17 and 38 pharmacy claims per 100,000 female enrollees, respectively. Injections had a delayed decreasing trend after the onset of the pandemic. The observed monthly unit cost of oral emergency contraception (EC) was at least twice the forecasted unit cost during the pandemic period ($86 vs. $38).

The immediate decrease in utilization of long-acting reversible contraception following the onset of the pandemic suggests barriers to access. The increase in the unit price of oral EC suggests that individuals with limited financial resources might face greater barriers to access.