Check out these resources to expand access to ECs

Is expanding access to emergency contraceptives (EC) on your personal goal list for 2001? If so, take a look at the EC Materials Database, now available on the Emergency Contraception web site (www.not-2-late.com).

The database, developed by the American Society for Emergency Contraception (ASEC) and the Consortium for Emergency Contraception (CEC), provides descriptions of EC educational and promotional materials from the United States and abroad, including client materials, provider education and training resources, and media campaign materials, says James Trussell, PhD, professor of economics and public affairs, faculty associate of the Office of Population Research, and associate dean of the Woodrow Wilson School of Public and International Affairs at Princeton (NJ) University.

The database allows organizations to share and adapt information, ideas, and graphics related to emergency contraception’s introduction and promotion. Materials are being added as they become available. When complete, the database will offer a comprehensive catalogue of available materials from around the world, including consumer educational materials; television, radio, and print media materials; medical guidelines; training curricula; and novelty items. Materials may be searched by type, language, target audience, target location, and sponsor organization.

ASEC and the CEC are committed to EC awareness. ASEC is a voluntary collaboration of organizations, founded in 1997, which promotes the option of emergency contraception for women. The CEC is an international-based collaboration committed to making a dedicated product for emergency contraception a standard part of reproductive health care around the world.

Pharmacist program eyed

EC proponents who are looking to establish collaborative practice agreements to expand EC availability in their states may wish to examine the findings in a just-published analysis of a pilot program launched in Washington state. (See the August 1999 issue of Contraceptive Technology Update, p. 85, for an overview of the Washington state project. Also see the January 2001 issue, p. 1, for a report on other states’ moves toward wider EC access.)

The new study’s results indicate that getting emergency contraceptive pills directly from a pharmacist within 72 hours of having unprotected sex can reduce the number of unintended pregnancies and save money for public and private payers.1

"Health care decision makers proposing collaborative arrangements in other states can use this information to demonstrate how pharmacist-provision of emergency contraception can reduce unintended pregnancies and save costs," says Kristin Marciante, MPH, a member of the Pharmaceutical Outcomes Research and Policy Program within the Department of Pharmacy at the Seattle-based University of Washington. "Public and private insurers can use our findings in conjunction with other information to drive their health care coverage decisions."

Because cost plays an important role in health care decision making, researchers sought to determine the cost and outcomes of increasing access to emergency contraception through pharmacist provision relative to the cost and outcomes occurring in the absence of the pharmacy service, says Marciante. "Our goal was to provide information to insurers considering providing coverage for pharmacist-prescribed emergency contraception and to health care decision makers considering implementing collaborative arrangements in other states," she notes.

Look at the study

The study investigated the effect on the risk and cost of unintended pregnancies of emergency contraceptive pills obtained directly from a pharmacist. Researchers used a decision model to compare outcomes for private and public payers.

The estimate incidence of pregnancy was reduced from 4.9% to 1.8% for women who obtained emergency contraceptives from pharmacies rather than from a physician or clinic or not at all. Obtaining emergency contraceptive pills from a pharmacy, compared with obtaining them from a physician or clinic, resulted in a $158 [95% confidence interval (CI) = $76, $269] reduction in costs for private payers and a $48 [95% CI = $16, $93] reduction for public payers.

"Emergency contraception is an effective method of reducing unintended pregnancy; however, because it must be used within 72 hours of unprotected sex, access can be problematic," Marciante observes. "Pharmacist provision of emergency contraception can facilitate use of the regimen within the 72-hour window because pharmacies are typically open outside of regular business hours."

Reference

  1. Marciante KD, Gardner JS, Veenstra DL, et al. Modeling the cost and outcomes of pharmacist-prescribed emergency contraception. Am J Public Health 2001; 91:1,443-1,445.