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- Title
Emergency contraception subsidy in Canada: a comparative policy analysis.
- Authors
Lee, Sabrina C.; Norman, Wendy V.
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
CANADA; QUEBEC (Quebec); POLICY analysis; CONTRACEPTION; DRUG formularies; COMPARATIVE studies; POLICY sciences; HEALTH policy; LEVONORGESTREL; EMERGENCY contraceptives; UNPLANNED pregnancy
- Publication
BMC Health Services Research, 2022, Vol 22, Issue 1, p1
- ISSN
1472-6963
- Publication type
journal article
- DOI
10.1186/s12913-022-08416-1