UBC researchers found that B.C.’s decision to provide universal, no-cost prescription contraceptives significantly reduced patient payments, with people in their 20s benefitting the most financially. Affordable contraceptives lead to higher rates of unintended pregnancies, with significant implications for health, education, and economic equality.
Published in JAMA Health ForumThis study is the first to quantify the impact on costs for patients after British Columbia introduces free prescription contraceptives in April 2023.
The highest payers benefit the most.
Before this policy was introduced, the average monthly price for the pill was about $25, but upfront costs for IUDs ranged from $75 to more than $500, and lifetime costs could reach $10,000 for long-term pill users.
Nearly 40 percent of prescribed contraceptives were not covered by insurance and were paid out of pocket by patients. This is the highest rate in Canada and far exceeds most other prescription drugs. Among young people, the number was even higher, at about 45 percent. After implementation, the out-of-pocket ratio decreased by approximately 33 percentage points. Across all patient groups, the proportion of patient costs for prescriptions fell to less than 10 percent, and the proportion of fully covered prescription contraceptives fell to 5 percent.
After two years, patient spending was 83% lower than expected, resulting in an average annual savings of $43 per contraceptive user.
People in their 20s often fall into coverage gaps. They are off of their parents’ plans, but they still don’t have jobs with benefits. This policy was especially important for this group, who were most likely to pay out of pocket. ”
Dr. Elizabeth Nethery, first author, Postdoctoral Researcher, UBC School of Pharmacy
System costs remain stable even as access expands
The study analyzed pharmacy data from all 10 states, comparing jurisdictions without universal health coverage. Although patient costs decreased significantly, total contraceptive spending across patients, insurers, and public systems remained essentially unchanged after two years. Researchers also found increased uptake of long-acting reversible contraceptives, such as IUDs and implants.
“Universal coverage works,” said lead author Dr. Laura Sumers, assistant professor at UBC. “Removing cost barriers increases uptake of the most effective methods, reduces unplanned pregnancies and inequalities, and adds to the strong evidence that universal contraception is essential in Canada.”
Approximately two in five pregnancies in Canada are unintended, disproportionately impacting those with the least financial means.
Policy momentum across Canada
Manitoba introduced a similar program in October 2024, and early results were consistent with B.C. At the federal level, Canada passed the Pharmacare Act, which commits to public coverage of contraception in 2024, but only three provinces and one territory currently participate in implementation agreements.
The study was funded by the Canadian Institutes of Health Research and included researchers from UBC, the University of Calgary, the University of Manitoba, Simon Fraser University and the University of Ottawa.
sauce:
University of British Columbia
Reference magazines:
Nethery, E. others. (2026) Universal free contraceptive coverage policy, copayments, and costs. JAMA Health Forum. DOI: 10.1001/jamahealthforum.2026.1269. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2849530
