Evaluation of the effect of contraceptive prices on demand in eight Western European countries.

Wide differences exist among European countries as regards national reimbursement schemes and the resulting individual expenditure on contraception. In this current research project annual expenditure and costs in the first year of use were calculated, taking into account existing reimbursement levels, for oral contraceptives, intrauterine devices, condoms, and sterilization in eight Western European countries: Italy, France, United Kingdom, Spain, West Germany, Austria, Sweden and Denmark. The costs were expressed in Swiss francs. For users of oral contraceptives it emerged that the annual expenditure on contraception ranged from nil in the United Kingdom to 172.32 Swiss francs in Austria. In the case of condoms, the cost to users was lowest in the United Kingdom (57.44 Swiss francs) and highest in Spain (105.95 Swiss francs). Expenditure on the use of an intrauterine device in the first year ranged from nil in the United Kingdom and Sweden to 449.87 Swiss francs in Austria, while sterilization was carried out free of charge in France, West Germany and Denmark, as compared with a cost of 677.57 Swiss francs in Italy. The variation in expenditure was largely explained by the extent to which contraception costs are reimbursed in the respective countries. Correlation of the calculated expenditure on a method and its use did not show any statistically significant trend. This suggests that the wide differences in the choice of contraceptive methods between countries are not related to differences in national reimbursement schemes and resulting costs to users, and that other factors must be involved.