That’s exactly what many women’s health advocates hope. Long-acting methods such as the IUD and the hormonal implant are nearly 100 percent effective, require no effort after insertion and protect against pregnancy for up to 10 years. (In contrast, birth control pills are about 92 percent effective, and many other common methods are even less reliable in everyday use.)
Some women worry that having a device inserted in the uterus or under the skin is riskier than methods such as a pill, a patch or a vaginal ring that they can discontinue at will.
But experts such as Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a nonprofit research center on reproductive policy, point out that IUDs and implants “eliminate the possibility of inconsistent use.”
They’re also among the most cost-effective methods available in the United States, according to research
by James Trussell, a professor of economics and public affairs at Princeton University. Among other things, Trussell factored in the cost of particular methods, their effectiveness at preventing pregnancy, and the costs of unintended pregnancy or other events during a five-year period. IUDs and vasectomies were found to be the most cost-effective. Implants were somewhat less cost-effective but still a better bet than oral contraceptives, the patch, the vaginal ring or injectable contraceptives, among others.
These longer-acting methods, however, carry a hefty upfront price tag of between $500 and $1,000 for the device itself and its insertion. Meanwhile, insurance coverage is uncertain. Although the vast majority of employer health plans cover contraception, they don’t necessarily cover all methods, and they generally don’t cover them for free. A 2004 study found that 40 percent of companies covered IUDs.
“For most plans, the devices aren’t considered part of the drug formulary, so you might have coinsurance of some amount like 20 percent,” Sonfield says.
Health care reform
Under the new health care law, starting this August, new employer health plans or those that change their benefits substantially will be required to cover all FDA-approved contraception methods and related counseling without co-pays. Catholic bishops and others strenuously objected to imposing this requirement on employers who objected to contraception on religious grounds. The Obama administration last week offered a compromise that would allow women who work for religious organizations to obtain contraception directly from an insurer — still without co-pays. But the debate continues.
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