Effect of the Affordable Care Act on the Cost of Intrauterine Device Insertion [10N]

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The Affordable Care Act (ACA), signed into US law in 2010, required health plans to cover preventative medicine at 100%. This service was extended to include contraception in 2012/2013. An analysis was conducted to compare the combined cost of intrauterine devices (IUDs) and insertion before and after the ACA.


Truven Health MarketScan database is a large claims database containing data from patients enrolled in employer and commercial health plans, including a sampling of Medicaid supplemental plans. Truven's Treatment Pathways 3.0 tool was used to retrospectively examine the total cost, including patient out-of-pocket cost and insurance reimbursement, associated with IUDs and insertion for the years 2010 through 2014. The data were summarized descriptively.


There was little change in the mean total cost for IUDs and insertion from 2010 to 2014 ($146.09 to $143.04, respectively; range: $137.43 to $146.09). On the other hand, mean patient out-of-pocket cost decreased substantially from $25.06 in 2012 to $5.88 in 2013 and $4.76 in 2014. A corresponding increase in mean insurance reimbursement from $112.36 in 2012 to $138.90 in 2013 and $138.27 in 2014 was noted.


While the overall mean cost of IUD insertion remained generally stable, a dramatic decrease in the cost to the patient was noted in 2013 following the ACA, which was sustained through 2014. Whether the decrease in patient out-of-pocket cost associated with IUD insertion will have an effect on the rate of IUD use among women in the US remains to be determined. Support: Teva Pharmaceuticals.

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