Changes in Hormonal Contraceptive Dispensing Trends Among Commercially Insured Kentucky Females During the COVID-19 Pandemic

新冠疫情期间肯塔基州商业保险女性激素避孕药发放趋势的变化

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Abstract

PURPOSE: To evaluate the impact of the COVID-19 national emergency declaration on contraceptive dispensing trends among commercially insured Kentucky females. METHODS: Data ranging from 1/7/2019 through 12/27/2020 for female enrollees aged 19-44 with a primary residence in Kentucky were extracted from the Merative Marketscan Commercial Claims and Encounters Database. A segmented regression analysis was used for statistical modeling of an interrupted time series design to describe changes in weekly contraceptive (oral, transdermal, and vaginal) dispensing rates and days' supply following the COVID-19 national emergency. RESULTS: A total of 90 541 enrollees met study inclusion criteria. The estimated weekly contraceptive dispensing rate per 100 reproductive-aged female enrollees was 3.22 (95% confidence interval [CI] 3.16-3.28) at the beginning of the pre-pandemic period. Following the national emergency, an immediate estimated rate increase of 0.11 (95% CI 0.01-0.21; p = 0.030) was seen with no change in trend. At the beginning of the pre-pandemic period, the estimated weekly percentage of days' supply > 28 days was 29.2% (95% CI 28.8-29.6) with an increasing trend of 1.1% every 10 weeks (slope 0.11 [95% CI 0.09-0.12; p < 0.001]). Following the national emergency, an immediate decrease of 1.5% (95% CI -2.2 to -0.8; p < 0.001) was observed, followed by sustainment of the pre-pandemic trend. No differential impacts were seen with regard to age group (19-26 vs. 27-44) or rural-urban classification. CONCLUSIONS: Following the COVID-19 national emergency declaration, trends in both contraceptive dispensing and days' supply among commercially insured Kentucky females were relatively stable, suggesting multiple behavioral and policy-related factors potentially overshadowing changes in access.

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