title: Cost as a barrier to long-acting reversible contraceptive (LARC) use in adolescents.
abstract: Cost is a major barrier to adolescents' ability to obtain long-acting reversible contraception (LARC). By reviewing the available literature on this issue, we provide a framework to understand how insurance coverage, out-of-pocket expenses, parental involvement, and recent pregnancy can impact access. We provide examples of cost-free access to LARC for adolescents, such as the Contraceptive CHOICE Project. Universal coverage for contraception, without cost-sharing, could increase use of LARC among adolescents resulting in fewer unintended pregnancies, improved health outcomes, and considerable cost savings to the healthcare system.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110, USA. eisenbergd@wudosis.wustl.edu
authors.forename: David
authors.initials: D
authors.lastname: Eisenberg
authors.forename: Colleen
authors.initials: C
authors.lastname: McNicholas
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000293:Adolescent; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007434:Intrauterine Devices / Q000191:economics* / Q000706:statistics & numerical data*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D055815:Young Adult