ArticleBMJ (Clinical research ed.)2025
Effect of universal no-cost coverage on use of long-acting reversible contraception and all prescription contraception: population based, controlled, interrupted time series analysis.
Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Impact of a free medication policy on blood pressure among older patients with hypertension: an interrupted time series analysis.BMC public health · 2026Article
- Universal Free Contraception Coverage Policy, Out-of-Pocket Payments, and Costs.JAMA health forum · 2026Article
- Advancing Maternal Health with Long-Acting Therapeutics: Priorities, Efficacy and Safety Considerations, and Emerging Technologies.Clinical pharmacology and therapeutics · 2026Review
- Contraceptive Barriers and Psychological Well-Being After Repeat Induced Abortion: A Systematic Review.Behavioral sciences (Basel, Switzerland) · 2025Review
- Data resource profile: PharmaNet, the database for prescription drug dispensing in British Columbia, Canada.International journal of population data science · 2023Article
- Article
- Canada leads international movement to enhance accessible, safe abortion services.Canadian family physician Medecin de famille canadienArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate effects of a policy introducing universal, no-cost public coverage for prescription contraception on use in British Columbia, Canada.
designPopulation based, controlled, interrupted time series analysis.
setting10 Canadian provinces.
participantsPrescription medications dispensed to reproductive aged (15-49 years) female residents of British Columbia, Canada, compared with a synthetic control derived from the nine other Canadian provinces and a population based cohort of 859 845 female individuals in British Columbia (age 15-49 years) between 1 April 2021 and 30 June 2024.
interventionIntroduction of a universal contraception coverage policy in April 2023, where the public insurer pays 100% of prescription costs. OUTCOME MEASURES: Number of monthly dispensations for long-acting reversible contraception (LARC) and number of monthly dispensations for all forms of prescription contraception (including LARC), percentage of reproductive aged female residents using LARC and using all forms of prescription contraception, and the proportion of people using prescription contraception who use LARC (LARC market share). Segmented regression models were used to estimate policy effects by comparing the expected outcome values after 15 months of the policy (ie, the counterfactual, derived from trends before the policy and changes in the control) with the observed values, with 95% confidence intervals (CIs) estimated using bootstrapping.
resultsIn April 2021, 3249 (95% CI 3066 to 3391) LARC prescriptions were dispensed in British Columbia, with a declining slope trend of -17 (-30 to -7) fewer dispensed per month before the policy. Monthly LARC dispensations increased by 1050 (942 to 1487) immediately after British Columbia's policy change and saw a steady increasing trend after the policy introduction. An additional 1273 (963 to 1698) monthly LARC prescriptions were dispensed 15 months after policy implementation compared with the expected volume, representing an estimated 1.49-fold (1.34 to 1.77) increase. Dispensations for all prescription contraception (including LARC) increased by 1981 (356 to 3324) per month, representing a 1.04-fold (1.01 to 1.07) increase. Among the 859 845 female residents aged 15-49 years in the population, 9.1% were using LARC in April 2021. 15 months after the policy, 11 375 (10 273 to 13 013) more individuals were using LARC than expected without the policy, representing an additional 1.3% (1.2% to 1.5%) of the population. The policy led to an additional 1.7% (1.5% to 2.3%) of the population using any prescription contraception. 15 months after the policy, the LARC market share was 1.9% (1.2% to 2.3%) higher than expected.
conclusionsUniversal, no-cost public coverage in British Columbia increased prescription contraception use overall, driven by increased LARC use. As such, cost seems to be an important contributor to contraception use and method selection at the population level.
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