Prescription birth control to be free in B.C. starting April 1, but not everything will be covered

British Columbia is set to make contraceptives free for those with a prescription starting April 1. 

Funding of $119 million over the next three years will allow full coverage for prescription contraception. It includes oral hormone pills, contraceptive injections, hormonal and copper intrauterine devices, subdermal implants, and Plan B, also known as the morning-after pill. Free prescription contraception will also be made available to men, including trans men.

To access free contraception, government officials said starting in April, residents covered under MSP must get a prescription from a family physician, then take it to their pharmacist with their MSP card to get it filled.

According to the provincial government's website, B.C. PharmaCare won't cover cervical caps, condoms, diaphragms, patches, rings or sponges. For some, these exclusions make the promise of free birth control ring hollow. 

Impact of exclusions on British Columbians  

Erin Knipstrom, a 41-year-old Maple Ridge woman who uses a transdermal patch, said she's frustrated that her form of contraception won't be covered. 

Other forms of birth control are not an option for her, she said. She said she and her doctor decided the patch is a non-invasive solution that has minimal side effects and doesn't exacerbate any secondary conditions.  

"Not covering these other birth controls is really unfair," she said. "So many women are affected and have different reasons for taking birth control."

Karlyn Roach, 31, from Kelowna says she's been using a transdermal patch for seven years after trying several methods. Although it functions as birth control for her as well, it's primarily to manage her pain from polycystic ovary syndrome (PCOS).

Roach, who works for Kelowna General Hospital, says she was let down after checking with her pharmacist whether she would be covered under the new program. 

"I just took one look at my husband, who was with me, and had a bit of a good cry because you feel very unseen.

"Ovulating people they don't just grab the first pill that's offered to them and it works miracles. Every single person is different," said Roach.

While Roach counts herself lucky that she's in a position to afford the roughly $450 a year for her medication, she worries for others who cannot. 

"Money talks. When someone already can't afford something or they can barely afford it, they are going to switch to something that is completely free because why wouldn't you, and they will do it to the detriment of their health."

Sara Eftekhar, a nurse practitioner and AccessBC campaign organizer, said that while offering free contraception is a step forward for reproductive justice, the omission of certain forms of birth control is concerning. 

She said the Ministry of Health has told AccessBC it is considering adding more forms of contraception in the future, but not all. However, there's no timeline or any response on what that process would look like. 

Currently, vaginal rings and the transdermal patch are covered under Plan W (First Nations Health Benefits). Coverage will continue for those beneficiaries.

Why the exclusion? 

According to Wendy Norman, a professor at the University of British Columbia's Dept. of Family Practice and research chair at the Public Health Agency of Canada, it comes down to the Canadian Agency for Drugs and Technologies in Health (CADTH).

It carries out reviews that dictate which drugs will be covered. 

Norman said it has found that the excluded options were no more effective than birth control pills, and often cost more and had more side effects. 

However, she says it doesn't take into consideration the context of people's lives. 

"We need a full range of contraceptives to be able to meet the different needs. There are so many reasons that people find different methods to be more suitable to them."