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The Editor’s Desk: The province and the pill

A long overdue decision to make prescription contraceptives free is a step forward for B.C. women
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More than 30 years ago, shortly after I had moved to Britain, I went to get a prescription for the birth control pill filled at the Boots pharmacy in Chester, near where I lived. It was my first time getting that prescription in the UK, and it was very much like getting it here in B.C.: I asked my physician for the prescription, then dropped it off at the pharmacy and was told to come back in 15 minutes or so.

When I went back and gave my name, the pharmacist passed me a small bag with six months’-worth of pills in it, then turned away and started helping the next customer. I stood there for a few moments, expecting someone to ask me to pay, and when no one did I asked what the cost was.

The woman turned back to me with a puzzled look on her face. “Is it for birth control?” she asked. (Note: birth control pills are not just prescribed for preventing pregnancy, although that is by far their most common use; they are also prescribed to some women because they can regulate menstruation, lower the risk of ovarian and uterine cancers, improve acne, and treat endometriosis.)

When I said yes, she shrugged and said “Then there’s no charge.” And that was that. For the five years I lived in the UK, I didn’t pay anything for birth control.

All that changed when I moved back to B.C., which also meant paying for the pill. Several years ago, while I was still on it, I switched brands, even though I still had a couple of boxes of the old prescription left. I asked my physician what I should do with them, and he asked if I could bring the unopened boxes in to the clinic. He was in the habit, you see, of using free drug company samples of the birth control pill to give to patients who couldn’t afford birth control, or had trouble accessing it. My unused pills would be welcomed by a woman whose position wasn’t as fortunate as mine.

I thought of both these stories recently, when the provincial government announced that it will now be providing free prescription birth control to all B.C. women who want it, whether that be oral contraceptives, copper and hormonal intrauterine devices (IUDs), hormonal injections, the morning-after pill, or anything else. Why it took so long for B.C. to catch up with many other places in the world that have offered free prescription contraceptives for decades is a mystery (and it should be noted that no other province in Canada currently offers it).

As for the cost: the announcement noted that a prescription for the pill costs (on average) $25 a month, and if that doesn’t sound like a barrier to you, then congratulations. For many women, however, that $25 a month might as well be $2,500 a month (and please don’t think that they can just cut out a latte a week; women for whom $25 a month for a prescription is a barrier are not enjoying many lattes, or enjoying much of anything about their lives, probably).

The province has also announced that starting this spring, B.C. pharmacists will be able to prescribe contraceptives, removing yet another barrier for many women. Studies have shown that approximately 40 per cent of pregnancies in B.C. are unintended. Increased, free access to a wide range of effective contraceptives will support women in planning and spacing out their pregnancies.

Oh, the total cost of the new free prescription contraceptive program? It’s estimated at $119 million in total over three years, or about $40 million a year. However, a 2010 study estimated that paying for prescription contraception would save the B.C. government about $95 million a year through reductions in abortions, prenatal visits, and social supports. Adjusted for inflation, that amount has almost certainly risen in the last 13 years.

So congratulations to the B.C. government for a sensible decision. It took a long time, but it (finally) got there in the end.



editorial@accjournal.ca

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