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Emergency contraception subsidy in Canada : a comparative policy analysis Lee, Sabrina C.; Norman, Wendy V.

Abstract

Background In Canada, cost prohibits access to emergency contraception (EC) which may assist to prevent unintended pregnancy. The drug, ulipristal acetate (UPA-EC), is more clinically effective and cost-effective than the prior standard levonorgestrel (LNG-EC). We analyzed provincial EC subsidization policies and examined underlying decision-making processes. Methods We undertook documentary analysis of provincial EC subsidization policies in publicly available drug formularies. We conducted semi-structured interviews with key informants to explore the processes underlying current policies. Results Quebec is the only province to subsidize UPA-EC, whilst all ten provinces subsidize LNG-EC. As such, provincial EC subsidization policies do not align with the latest UPA-EC evidence. Interviews revealed that evidence was valued in the policymaking process and formulary decisions were made through interdisciplinary consensus. Conclusions We identify a gap between EC subsidization policies and the latest evidence. Institutional structures affect policies reflecting evolving evidence. Increasing interdisciplinary mechanisms may encourage evidence-based policies.

Item Metadata

Title
Emergency contraception subsidy in Canada : a comparative policy analysis
Creator
Lee, Sabrina C.; Norman, Wendy V.
Publisher
BioMed Central
Date Issued
2022-09-01
Description
Background In Canada, cost prohibits access to emergency contraception (EC) which may assist to prevent unintended pregnancy. The drug, ulipristal acetate (UPA-EC), is more clinically effective and cost-effective than the prior standard levonorgestrel (LNG-EC). We analyzed provincial EC subsidization policies and examined underlying decision-making processes. Methods We undertook documentary analysis of provincial EC subsidization policies in publicly available drug formularies. We conducted semi-structured interviews with key informants to explore the processes underlying current policies. Results Quebec is the only province to subsidize UPA-EC, whilst all ten provinces subsidize LNG-EC. As such, provincial EC subsidization policies do not align with the latest UPA-EC evidence. Interviews revealed that evidence was valued in the policymaking process and formulary decisions were made through interdisciplinary consensus. Conclusions We identify a gap between EC subsidization policies and the latest evidence. Institutional structures affect policies reflecting evolving evidence. Increasing interdisciplinary mechanisms may encourage evidence-based policies.
Subject
Ulipristal acetate; Emergency contraception; Universal subsidy; Canada; Health policy; Evidence-based policy
Genre
Article
Type
Text
Language
eng
Date Available
2023-06-26
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0433743
URI
http://hdl.handle.net/2429/85154
Affiliation
Medicine, Faculty of; Non UBC; Family Practice, Department of
Citation
BMC Health Services Research. 2022 Sep 01;22(1):1110
Publisher DOI
10.1186/s12913-022-08416-1
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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DSpace

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Attribution 4.0 International (CC BY 4.0)