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新冠疫情期间肯塔基州商业保险女性激素避孕药物发放趋势的变化

Changes in Hormonal Contraceptive Dispensing Trends Among Commercially Insured Kentucky Females During the COVID-19 Pandemic.

作者信息

Miracle Dustin K, Hammerslag Lindsey R, Slavova Svetla, Lei Feitong, Talbert Jeffery, Moga Daniela C, Freeman Patricia R

机构信息

Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA.

Institute for Biomedical Informatics, University of Kentucky, Lexington, Kentucky, USA.

出版信息

Pharmacoepidemiol Drug Saf. 2025 May;34(5):e70159. doi: 10.1002/pds.70159.

Abstract

PURPOSE

To evaluate the impact of the COVID-19 national emergency declaration on contraceptive dispensing trends among commercially insured Kentucky females.

METHODS

Data ranging from 1/7/2019 through 12/27/2020 for female enrollees aged 19-44 with a primary residence in Kentucky were extracted from the Merative Marketscan Commercial Claims and Encounters Database. A segmented regression analysis was used for statistical modeling of an interrupted time series design to describe changes in weekly contraceptive (oral, transdermal, and vaginal) dispensing rates and days' supply following the COVID-19 national emergency.

RESULTS

A total of 90 541 enrollees met study inclusion criteria. The estimated weekly contraceptive dispensing rate per 100 reproductive-aged female enrollees was 3.22 (95% confidence interval [CI] 3.16-3.28) at the beginning of the pre-pandemic period. Following the national emergency, an immediate estimated rate increase of 0.11 (95% CI 0.01-0.21; p = 0.030) was seen with no change in trend. At the beginning of the pre-pandemic period, the estimated weekly percentage of days' supply > 28 days was 29.2% (95% CI 28.8-29.6) with an increasing trend of 1.1% every 10 weeks (slope 0.11 [95% CI 0.09-0.12; p < 0.001]). Following the national emergency, an immediate decrease of 1.5% (95% CI -2.2 to -0.8; p < 0.001) was observed, followed by sustainment of the pre-pandemic trend. No differential impacts were seen with regard to age group (19-26 vs. 27-44) or rural-urban classification.

CONCLUSIONS

Following the COVID-19 national emergency declaration, trends in both contraceptive dispensing and days' supply among commercially insured Kentucky females were relatively stable, suggesting multiple behavioral and policy-related factors potentially overshadowing changes in access.

摘要

目的

评估新冠疫情国家紧急声明对肯塔基州商业保险女性避孕药具配药趋势的影响。

方法

从默克多市场扫描商业索赔与诊疗数据库中提取2019年1月7日至2020年12月27日期间主要居住在肯塔基州的19 - 44岁女性参保者的数据。采用分段回归分析对中断时间序列设计进行统计建模,以描述新冠疫情国家紧急声明后每周避孕药具(口服、经皮和阴道用)配药率及供应天数的变化。

结果

共有90541名参保者符合研究纳入标准。在疫情前时期开始时,每100名育龄女性参保者的估计每周避孕药具配药率为3.22(95%置信区间[CI] 3.16 - 3.28)。国家紧急声明后,估计配药率立即上升0.11(95% CI 0.01 - 0.21;p = 0.030),且趋势无变化。在疫情前时期开始时,估计每周供应天数> 28天的比例为29.2%(95% CI 28.8 - 29.6),每10周上升趋势为1.1%(斜率0.11 [95% CI 0.09 - 0.12;p < 0.001])。国家紧急声明后,立即下降1.5%(95% CI -2.2至 -0.8;p < 0.001),随后维持疫情前趋势。在年龄组(19 - 26岁与27 - 44岁)或城乡分类方面未观察到差异影响。

结论

新冠疫情国家紧急声明后,肯塔基州商业保险女性的避孕药具配药及供应天数趋势相对稳定,表明多种行为和政策相关因素可能掩盖了获取方面的变化。

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