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Invited Commentary
July 8, 2019

Expanding Access to Short-Acting Hormonal Contraceptive Methods in the United States

Author Affiliations
  • 1Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
JAMA Intern Med. 2019;179(9):1209-1210. doi:10.1001/jamainternmed.2019.1676

In this issue of JAMA Internal Medicine, the article by Judge-Golden et al1 provides further evidence that dispensing a larger supply of contraception is cost-effective. This economic decision model explored the financial implications for the Veteran Affairs (VA) health care system of offering beneficiaries 12 months of oral contraceptive pills (OCPs) in a single prescription. Across a range of sensitivity analyses, the authors found that the 12-month dispensing option was cost saving to the VA compared with the standard 3-month dispensing option, largely owing to the reduction in unintended pregnancy.

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1 Comment for this article
Personal Responsibility in danger of extinction
Gerry Silverstein, PhD | University-Emeritus Lecturer in Microbiology & Molecular Genetics
"45% of all pregnancies are reported to be unwanted or mistimed,suggesting that people’s contraceptive needs are not being fully met."

According to the terms of the ACA, 18 different types of contraception have been made available absolutely free with no co-pays and no deductibles (condoms are not provided free even though they not only prevent unwanted pregnancies---if used correctly--- they also prevent spread of STDs).

Included in the 18 are 8 different contraception methods that have a 99% or greater efficacy in preventing unwanted pregnancies (when used correctly).

So are people's contraceptive needs "not
being met", or are people not accepting the personal responsibility for using (correctly) what is readily available and free?

There is no more sacred an act that 2 human beings can engage in then the creation of a human being, yet as in so many aspects of daily living in this country (physical inactivity, excess caloric and alcohol intake, etc), individuals are failing to take the necessary steps to prevent an unwanted pregnancy when the creation of a new human being is not desired.

We have become a society in which individual failings are always someone else's fault or the fault of society at large. I submit that such a society has a limited lifespan.