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. 2022 Sep 1;22(1):1110.
doi: 10.1186/s12913-022-08416-1.

Emergency contraception subsidy in Canada: a comparative policy analysis

Sabrina C Lee  1   2 , Wendy V Norman  3   4
Affiliations

Emergency contraception subsidy in Canada: a comparative policy analysis

Sabrina C Lee et al. BMC Health Serv Res. .

Abstract

Background: In Canada, cost prohibits access to emergency contraception (EC) which may assist to prevent unintended pregnancy. The drug, ulipristal acetate (UPA-EC), is more clinically effective and cost-effective than the prior standard levonorgestrel (LNG-EC). We analyzed provincial EC subsidization policies and examined underlying decision-making processes.

Methods: We undertook documentary analysis of provincial EC subsidization policies in publicly available drug formularies. We conducted semi-structured interviews with key informants to explore the processes underlying current policies.

Results: Quebec is the only province to subsidize UPA-EC, whilst all ten provinces subsidize LNG-EC. As such, provincial EC subsidization policies do not align with the latest UPA-EC evidence. Interviews revealed that evidence was valued in the policymaking process and formulary decisions were made through interdisciplinary consensus.

Conclusions: We identify a gap between EC subsidization policies and the latest evidence. Institutional structures affect policies reflecting evolving evidence. Increasing interdisciplinary mechanisms may encourage evidence-based policies.

Keywords: Canada; Emergency contraception; Evidence-based policy; Health policy; Ulipristal acetate; Universal subsidy.

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Conflict of interest statement

There were no financial or non-financial competing interests for either author.

Figures

Fig. 1
Fig. 1
Drug subsidization process in Canada
See this image and copyright information in PMC

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