Real-world patterns of prescription refills for branded hormonal contraceptives: a reflection of contraceptive discontinuation

Abstract

Objective: The objective was to describe timely refills of hormonal contraceptive products among a large, geographically diverse population of U.S. women as an estimate of method continuation over time.

Methods: Longitudinal prescription refills from the Verispan database were collected from 99% of retail pharmacies in the United States between October 2003 and August 2005 for specific branded hormonal contraceptives. We calculated refill rates for different contraceptive categories, for individual products, and for different age groups.

Results: Refill data were available for nearly 1.7 million women for 240 days and for almost 1 million women for 420 days. After 30 days, only 59.4-75.1% of women refilled their prescriptions for the various products on a timely basis. By 3 months, only 47.7-61.2% of women returned for timely refills. By 12 months, only 16.3-34.5% of women had consistently refilled their prescriptions. Very young women had refill rates for most methods that were at least as good as those of older women.

Conclusion: These low rates of timely refill rates in actual practice indicate that few women had the potential for correct and consistent contraceptive use. New methods with extended cycles or a new progestin had higher rates than did other 28-day products. These high discontinuation rates suggest that barriers to successful utilization of contraceptives exist, and they highlight the need to routinely provide condoms and emergency contraception to women initiating hormonal contraception.