1. Impact of Coronavirus disease 2019 (COVID-19) on contraception use in 2020 and up until the end of April 2021 in France
- Author
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Noémie Roland, Jérôme Drouin, David Desplas, Lise Duranteau, François Cuenot, Rosemary Dray-Spira, Alain Weill, Mahmoud Zureik, HAL UVSQ, Équipe, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, EPI-PHARE (EPI-PHARE), Caisse nationale d'assurance maladie des travailleurs salariés [CNAMTS]-Agence nationale de sécurité du médicament et des produits de santé [Saint-Denis] (ANSM), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM, Funding: This research was funded by EPI-PHARE, the French National Health Insurance Fund (CNAMTS) and the French National Agency for Medicines and Health Products Safety (ANSM). NR, DD, FC, RDS and MZ are employees of the French National Agency for Medicines and Health, JD and AW of the French National Health Insurance Fund., and Each author has confirmed compliance with the journal's requirements for authorship. We thank Anthony Saul for his help in correcting and clarifying the manuscript. Funding: This research was funded by EPI-PHARE, the French National Health Insurance Fund (CNAMTS) and the French National Agency for Medicines and Health Products Safety (ANSM). NR, DD, FC, RDS and MZ are employees of the French National Agency for Medicines and Health, JD and AW of the French National Health Insurance Fund. Declarations of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Adult ,Adolescent ,Levonorgestrel ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,Article ,Young Adult ,Pregnancy ,Contraceptive Agents, Female ,Humans ,Pandemics ,SARS-CoV-2 ,Infant ,Obstetrics and Gynecology ,Healthcare access ,[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,Contraception ,Reproductive Medicine ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Communicable Disease Control ,Reproductive health ,Contraceptive methods ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Sexual Health ,Contraception, Postcoital ,Covid-19 - Abstract
International audience; Objectives: To assess the impact of the COVID-19 pandemic on the use of reimbursed contraceptives in France after 15 months of the pandemic, according to age-group and updating previous data only pertaining to the first lockdown (2 months). Study design: We conducted a national register-based study by extracting all reimbursements of oral contraceptives (OC), emergency contraception (EC), intrauterine devices (IUD), and implants from the French National Health Insurance database (SNDS), which includes and covers 99.5% of the French population, in 2018, 2019, 2020 and from January 1, 2021 to April30, 2021. We calculated the expected use of contraceptives in 2020 and 2021 in the absence of the pandemic, based on 2018 and 2019 usage and taking annual trends into account. We assessed the difference between observed and expected dispensing rates by contraceptive type and by age-group (≤18 years old, 18< age ≤25, 25< age ≤35, >35). Results: Dispensing of all contraceptives decreased compared to expect dispensing numbers: −2.0% for OC, −5.3% for EC, −9.5% for LNG-IUS, −8.6% for C-IUD, and −16.4% for implant. This decrease in the dispensing of contraceptives was observed in all age-groups, but mainly concerned women under the age of 18 years (−22% for OC, −10% for EC, −37.2% for LNG-IUS, −36.4% for C-IUD, −26.4% for implant) and those aged 18 to 25 (−5.1% for OC, −11.9% for EC, −18.1% for LNG-IUS, −15.9% for C-IUD, −17.6% for implants). Conclusions: Our study showed that the dispensing of contraceptives in France was markedly impacted by the COVID-19 pandemic. Prescriptions for long-acting contraceptive use and women under the age of 25 years were the most substantially impacted. Ensuring access to contraceptive methods during health emergencies must be a public health policy priority. Implications: The COVID-19 pandemic strongly impacted the dispensing of contraceptives in France with varying degrees of decreased dispensing according to the type of contraceptive, the age-group and the level of pandemic-related restrictions. The impact of these restrictions on unintended pregnancy at the population level remains undetermined.
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- 2022