Sunday, World Contraception Day, the AccessBC Campaign, joined by Action Canada for Sexual Health and Rights, the Abortion Rights Coalition of Canada (ARCC), CoverContraceptiON, and Birth Control Access for Manitoba, are calling for universal no-cost prescription contraception in British Columbia and across all of Canada.
These sexual and reproductive health advocates are urging the B.C. government to fulfill its recent election promise to make all prescription contraception free, and calling on governments across Canada to follow suit.
“Canada is the only country in the world with universal healthcare and no national pharmacare strategy,” said Frederique Chabot, Director of Health Promotion for Action Canada for Sexual Health and Rights, in a news release. “Being able to get the pill or an IUD should not depend on what’s in our bank account or on patchwork insurance. The time to act is now!”
This call to action comes as the COVID-19 pandemic has highlighted the need to remove barriers to contraception.
“Existing barriers to accessing contraception in our healthcare system, like cost, being a young person, or living in rural, northern, or Indigenous communities, are being magnified by the pandemic,” said Dr. Ruth Habte, a Resident Physician in Obstetrics and Gynaecology and Campaign Organizer. “The impact of cost, however, cannot be overstated. The pandemic has caused sweeping layoffs or cuts to hours and, as a result, has squeezed personal budgets tighter than before. This, coupled with the already patchwork of coverage in our healthcare system, means that people will continue to fall through the cracks.”
Currently, an intrauterine device (IUD) can cost $75 to $380, oral contraceptive pills can cost $20 per month, and hormone injections as much as $180 per year. These costs are a significant barrier to accessing contraception for many people across Canada, and fall particularly on women and people who can get pregnant.
“Access to contraception is an issue of equity – barriers to access such as cost fall disproportionately on people with uteruses, and more significantly affect those who are socioeconomically disadvantaged,” said Marisa Levesque, UBC medical student and AccessBC Campaign member. “Allowing all people to make choices about if and when they have children promotes gender equity in areas such as educational attainment and lifetime earnings.”
In Canada, unintended pregnancies cost Canadian health systems over $61 million annually, according to the group. Studies have shown that providing universal contraception coverage could see that entire amount saved in as little as six to 12 months. An Options for Sexual Health study from 2010 estimated that the BC government could save as much as $95 million annually – nearly twice the projected cost of implementing this policy. A separate 2015 study in the Canadian Association Medical Journal estimated that the annual cost of delivering universal contraception across Canada would be $157 million, but the savings – for direct medical costs of unintended pregnancy alone – would be approximately $320 million.
“Funding prescription contraception is not only a significant money saver for government, it’s the right thing to do,” said Joyce Arthur, Executive Director of Abortion Rights Coalition of Canada (ARCC). “No-one should have to risk an unwanted pregnancy because they can’t afford effective contraception. Reproductive rights are human rights. Covering the cost of contraception is a matter of equality for women and gender minorities.”
“I see on a daily basis patients who cannot get their best contraceptive method choice because of financial barriers,” said Dr. Helen Pymar, gynecologist member of Birth Control Access for Manitoba. “Hormonal contraception also has added benefits of managing painful and/or heavy periods which can reduce emergency room visits, development of endometrial and ovarian cancer, and improve quality of life.”
Reflecting on current evidence, universal coverage of contraception in Canada through a universal government plan is an effective method to increase healthcare equity and access. Sexual and reproductive health advocates are calling on provincial governments to:
Provide universal no-cost prescription contraception;
Ensure these programs include all prescription contraceptive methods, including hormonal IUDs, non-hormonal IUDs, and the contraceptive implant;
Commit to including future prescription contraception methods under this policy;
Create a plan to implement the policy equitably, taking into account factors such as race, ethnicity, gender, sexuality, age, and location;
Work to remove other barriers that people face when trying to access sexual and reproductive healthcare and services.
“Every person in Canada has a right to sexual and reproductive health. Governments have an obligation to provide the essential medicines that uphold those rights. Universal cost coverage for contraceptives is necessary to make sure people can choose if or when to become parents and space pregnancies,” said Frederique Chabot. “Choice and access to family planning are central to individual reproductive autonomy, gender equality and health and well-being.”