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About the Issue
The motivation behind AccessBC's campaign is simple - there are too many people in BC who need prescription contraception and can't get it. As of 2016, about 61% of Canadian women have had an unplanned pregnancy - but at the same time, use of more reliable contraception methods like the pill have dropped markedly since 2006. Nearly one in 10 sexually active teens aren't taking any steps to prevent pregnancy.
A recent study from UBC found that "young, low-income women in Canada are less likely to use more effective methods of birth control like the pill, and more likely to use no contraception or condoms only." And that "improving access to affordable contraception may decrease the number of young women at risk of unintended pregnancy due to financial barriers."
Cost remains a significant barrier to people accessing contraception. An intra-uterine device (IUD) can cost between $75 and $550, oral contraceptive pills cost at least $240 per year, a hormone injection can cost as much as $180 per year, and an implant can cost around $350. Such costs represent a significant barrier, particularly to people with low incomes, youth, and women from marginalized communities.
While there are a small number of programs in place support access to contraception (such as Fair PharmaCare in BC), these programs are largely income dependent.
Someone should not have to pass a means test or face financial burdens in order to freely exercise their right make choices about their reproductive health.
Cumbersome application processes and paperwork further discourage the use of these programs and represent additional barriers.
High costs of contraception significantly impact young people. While young adults may be covered through their parent’s plans, because a parent is almost always the primary subscriber for health insurance, a young person is therefore often forced to give up their privacy in order to make choices about their bodies. You should not have to sacrifice your privacy in order to exercise your rights!
Many other countries already subsidize prescription contraception, in full or in part; these include UK, France, Spain, Sweden, Denmark, the Netherlands, Italy, Germany, and Luxembourg. These countries have done so because the personal, public health, and social benefits far outstrip the costs.
In fact, programs that offer free prescription contraception to women have been found to be revenue positive! This is because the cost of providing free prescription contraception to women is considerably lower than the costs associated with unintended pregnancy.
Options for Sexual Health (2010) estimated that every $1 spent on contraceptive support for a person can save as much as $90 in public expenditure on social supports. The Contraception & Abortion Research Team (CART), Contraception Cost-effectiveness modelling project team, at UBC, recently estimated that the policy would save the BC health system $27 million, or over $5 per BC resident, per year.
Access to contraception is also a gender equality issue - right now, women and people with uteruses get the short end of the stick almost every time when it comes to reproductive costs. While condoms can be easily found for little or no cost, and vasectomies are covered under MSP, the most reliable contraception methods for people with uteruses are only available with prescriptions, and can cost anywhere from around $20 per month for the Pill to $350 for an IUD or implant. If an unplanned pregnancy occurs, most of those costs fall disproportionately on women as well.
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It is good social policy. Removing all barriers to accessing contraception is a powerful affirmation of the right of people to determine for themselves when and whether to become pregnant and bear children, a right supported in both federal and provincial arenas.
It is good health policy in both the preventive and therapeutic spectra. The measure will improve health outcomes for mothers and infants by reducing the risks associated with unintended pregnancy, particularly among adolescents and by maximizing the health benefits and outcomes of preparing for planned pregnancy.
It is good economic policy. The investment will yield a significant return in reduced public expenditure beyond the cost.
It is good education policy. The availability of publicly funded contraception will have a significant impact on normalizing the conversation about sexual and reproductive health, and on increasing the likelihood that school sexual health curriculum includes comprehensive, factual and non-judgmental information on contraceptive use.
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Victory in British Columbia!
The BC NDP committed to making all prescription contraception free in their 2020 election platform (see page 14). Both the BC Liberals and BC Greens (page 10) supported free prescription contraception during the election. Note that PST is not charged on contraception.
The 2020 and 2022 mandate letters of Adrian Dix, the Minister of Health, included the mandate to "Make prescription contraception free for all.
The policy was recommended by the Select Standing Committee on Finance and Government Services in its 2020 (p.47), 2021 (p.114), and 2022 (p.104) Budget Consultation Reports.
On February 28, 2023, the provincial government released the Budget 2023 which included free prescription contraception! The government is allocating $119 million over 3 years to cover the cost of this policy. On April 1, 2023, BC became the first province in Canada to implement universal no-cost prescription contraception!
The current plan in BC covers most forms of prescription contraceptives, including most oral hormone pills, contraceptive injections, copper and hormonal intrauterine devices, subdermal implants, the contraceptive ring, and Plan B (also known as the morning-after pill).
In BC, this policy has already improved access to contraceptives for thousands of residents. A recent article in the Martlet reported that in the first 15 months of the program, 252,000 British Columbians access free prescription contraception: 152,200 patients accessed hormonal pills, 48,200 accessed hormonal IUDs, 9,500 patients received hormonal injections, 7,500 received a copper IUD, 7,400 had an implant, and 2,000 received a vaginal ring.
The policy has helped increase contraception usage. Recent research from UBC found that by June 2024, of the 80,200 people in BC using long-acting reversible contraceptives (such as IUDs and implants), and 11,400 of these people would not have been had the government not enacted free prescription contraception. This research also found that the number of people using any form of prescription contraception also increased by 10%. And the policy has also reduced the number of people paying out of pocket for prescription contraception, from 37% before the policy was implemented, to only 13% in June 2024.
Bill C-64, An Act respecting pharmacare, receive royal assent on October 10, 2024. This bill commits the Government of Canada to working collaboratively with provinces and territories
towards the step-by-step implementation of national universal Pharmacare. This groundbreaking plan will make diabetes medication and prescription contraception free across Canada. The next step in its implementation requires provincial and territorial governments to sign agreements with the federal government.
On September 12, 2024, British Columbia became the first Canadian province to sign a memorandum of understanding (MOU) with the federal government. And on March 6, 2025, the BC government signed a formal agreement with the federal government around pharmacare. As result, BC will build on its existing free contraception policy, adding coverage for diabetes medication, equipment and supplies, and coverage for menopause hormone therapy (HMT) also known as hormone replacement therapy as treatment (HRT) for symptoms of menopause.
If you are looking for more information about contraception and access in BC, or would like to learn more about different contraception options, you can find out more by visiting Options for Sexual Health or Island Sexual Health.
If you are more of an audio person, you can learn more about the issue by tuning in to this September 2021 talk by Dr. Ruth Habte, entitled: "Reproductive Justice, Health Equity & the Campaign for No-Cost Contraception in BC," for the Centre for Gender and Sexual Health Equity.
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