A study by researchers at the University of British Columbia found B.C.’s universal contraception policy has significantly reduced patient costs, particularly for young adults.
B.C. introduced free prescription contraception in April 2023, including contraceptive pills, injections, intrauterine devices (IUDs), subdermal implants and levonorgestrel, also known as the morning-after pill. As of March 2026, contraceptives in B.C. are covered through Pharmacare funding from the federal government.
The study, published last month in Jama Health Forum, is the first to look at the cost impacts for patients. It examined data from two years before and two years after the policy was introduced.
Dr. Elizabeth Nethery, a postdoctoral research fellow in the Faculty of Pharmaceutical Sciences at UBC and lead author of the study, said before the policy British Columbians were generally paying more for contraception than residents of other provinces.
She said the pill cost patients about $25 per month, on average, which could add up to around $10,000 over the course of a person’s reproductive life. IUDs could range from $75 to more than $500 in up-front costs.
“We found that up to almost 40 per cent of contraception was being paid out of pocket. That is a really staggering high amount compared to other provinces and much higher than what we know for other medication groups,” said Nethery.
She said that figure was even higher among young adults, at about 45 per cent.
Study co-author and UBC Pharmaceutical Sciences assistant professor Dr. Laura Schummers said people aged 20-29 benefited the most by B.C.’s switch to universal coverage. She said that is likely because people in that age group might fall off their parent’s insurance plan, but not yet have a job that offers coverage.
“This is really a critical gap in that age range,” said Schummers. “Also important to note, this is when people are the most fertile, so age 20 to 29 is when it’s actually much easier to become pregnant than in older age periods.”
The researchers said British Columbians in their 20s were previously paying up to $75 a year out-of-pocket for contraception. After universal coverage was introduced, that amount fell as low as nine dollars per year, on average.
Across all ages, the policy resulted in about 10 per cent of all contraceptives requiring any out-of-pocket cost for patients, compared to around 40 per cent before 2023.
The study estimated that two years after the policy was introduced, out of pocket costs decreased by about $43 a year per contraceptive user.
The researchers said there’s also evidence that the policy has cost benefits for the health care system as well.
Nethery said because the policy offers partial coverage of brand-name drugs up to the cost of the generic version, B.C. saw more people switch to brand-name drugs as they became more affordable.
“That is also saving the system money because it’s reducing the amount that we’re paying for these contraceptives,” she said.
The study found there was also a major shift in the types of contraception British Columbians were using, with more people opting for longer-acting IUDs instead of pills.
Schummers said while IUDs have a larger up-front cost than other methods, they are a more effective method of contraception, and some devices are effective for up to 10 years, which brings down the total costs for the government over time.
“I think these findings…tell us that people were preferentially using less effective methods because of cost, and when that cost was removed altogether as a barrier, the population had a sea change shift toward the more effective methods,” said Schummers. “By taking costs out of the equation, people can just choose their preferred method and the method that feels right.”
Nethery said their research suggests the policy could have other major downstream cost savings for the public health system, as there may be fewer unintended pregnancies, abortions and surgeries.
“What we expect to see next is how good this will be for public health system spending, that we will spend less from this policy change, not more,” said Schummers.
There are also key social benefits of having universal access to contraceptives, rather than private insurance coverage, the researchers said, including better privacy and confidentiality.
“We don’t have to worry about people choosing to pay out of pocket because they are afraid of having this coverage show up on a drug plan that is shared potentially by a parent or a spouse,” said Nethery.
The researchers pointed to global evidence showing that access to birth control leads helps alleviate generational poverty and improve gender equality.
“This is a huge win for B.C.,” said Schummers. “We know that this policy works. And so it really is calling on the rest of Canada to start joining us, hopefully, in this investment and really making this something that is equitable for women across all Canadian provinces.”
