title: Are women benefiting from the Affordable Care Act? A real-world evaluation of the impact of the Affordable Care Act on out-of-pocket costs for contraceptives.
abstract: The Affordable Care Act (ACA) mandated that, starting between August 1, 2012 and July 31, 2013, health plans cover most Food and Drug Administration (FDA)-approved contraceptive methods for women without cost sharing. This study examined the impact of the ACA on out-of-pocket expenses for contraceptives.
  
  
  
  Women (ages 15-44years) with claims for any contraceptives in years 2011, 2012 and 2013 were identified from the MarketScan Commercial database. The proportions of women using contraceptives [including permanent contraceptives (PCs) and non-PCs: oral contraceptives (OCs), injectables, patches, rings, implants and intrauterine devices (IUDs)] in study years were determined, as well as changes in out-of-pocket expenses for contraceptives during 2011-2013. Demographics, including age, U.S. geographic region of residence and health plan type, were also evaluated.
  
  
  
  The number of women identified with any contraceptive usage in 2011 was 2,447,316 (mean age: 27.6years), in 2012 was 2,515,296 (mean age: 27.4years) and in 2013 was 2,243,253 (mean age: 27.4years). In 2011, 2012 and 2013, the proportions of women with any contraceptive usage were 26.3%, 26.2% and 26.9%, respectively. Over the three study years, mean total out-of-pocket expenses for PCs and non-PCs decreased from $298 to $82 and from $94 to $30, respectively. For non-PCs, mean total out-of-pocket expenses for OCs and IUDs decreased from $86 to $26 and from $83 to $20.
  
  
  
  Implementation of the ACA has saved women a substantial amount in out-of-pocket expenses for contraceptives.
  
  
  
  Mean total out-of-pocket expenses for FDA-approved contraceptives decreased approximately 70% from 2011 to 2013. Implementation of the ACA has saved women a substantial amount in out-of-pocket expenses for contraceptives. Longer-term studies, including clinical outcomes, are warranted.
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA. Electronic address: amy.law@bayer.com.
authors.forename: A
authors.initials: A
authors.lastname: Law
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
authors.forename: L
authors.initials: L
authors.lastname: Wen
authors.affiliation: Novosys Health, Green Brook, NJ, USA.
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
authors.forename: M
authors.initials: M
authors.lastname: Tangirala
authors.affiliation: Wharton School of Business, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Schwartz
authors.affiliation: Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA.
authors.forename: E
authors.initials: E
authors.lastname: Zampaglione
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000191:economics* / Q000600:supply & distribution; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000706:statistics & numerical data*; D060728:Reproductive Health / Q000191:economics; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female
keywords: Affordable Care Act; Contraceptives; Cost-savings; Out-of-pocket expenses