Report costs free contraception scheme at €10m, half official estimate

The introduction of free contraception for all women aged 17-25 in Budget 2022 would cost the State about €10 million a year, according to a framework report which will be presented to the Government this week.

The estimate is half the cost anticipated by a working group set up by the Department of Health. The introduction of free contraception for women aged 17-25 is provided for in the programme for Government.

Speaking on Sunday, World Contraception Day, Minister for Health Stephen Donnelly said rolling out the programme is a "ministerial priority".

Fears have been raised in recent weeks that the plan could be in jeopardy due to the huge outlay for services related to the Covid-19 pandemic.

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The research underpinning the report was conducted by DHR Communications and Dr Fergus Ryan of the Department of Law at NUI Maynooth. It consulted more than 30 groups and individuals including medics, students, LGBTI groups, migrant women and others.

In the report, which was funded by life sciences giant Bayer with the support of the Irish Family Planning Association (IFPA), the pharmaceutical company built a "budget impact model" from the perspective of the Health Service Executive (HSE) accounting for direct costs of funding.

Taking a mid-point of rates charged in the private market, the report suggests the annual cost of a scheme for 17-25 year-olds would be €10 million in 2022, rising to €10.8 million in 2026 due to population changes. The report also makes the case for such a scheme to be introduced without delay, noting that contraception “is critical to good health, wellbeing and gender equality”.

Asked about its costings, the department said: “The full-year costs of providing [free] contraception for 17-24 year-old women have been estimated by the working group on contraception at €18-22 million.

“Scaling up the costs to cover 17-25 year-olds would give a cost range of €20-€25million.”

The Bayer report contains an analysis of IFPA client data in 2019 which found that 68 per cent of women who accessed abortion care services were not using contraception. One in five were using condoms; 8 per cent were using short-acting methods, such as the pill; while 2 per cent were using “high-risk strategies” such as withdrawal. A 2021 audit by the Southern Task Group on Abortion and Reproductive Topics of 475 women accessing abortion care found “a virtually identical pattern”.

The report also pointed out that as the Covid-19 vaccination programme concludes and Irish society more fully reopens, demand for sexual and reproductive health services “will likely increase”.

Until universal free access to contraception is provided for, the report argues, it will remain “an unacceptable contradiction” that women can avail of abortion services without a cost burden but not their preferred form of contraception. It says the scheme should cover the full range of female contraceptive methods, including all forms of long-acting reversible contraception such as intrauterine devices (IUDs) and subdermal contraceptive implants, as well as emergency contraception.

It argues the cost of contraception is “a burden which primarily and disproportionately falls on women”. For some, this cost is “prohibitive” and results in limited choice and over-reliance on less effective methods that have a higher risk of failure.

“The gender inequality in cost and burden can only be resolved by State funding to remove the cost barrier of access to, and choice of, contraceptives,” it adds.