Comparison of contraceptive sales before and during the COVID-19 pandemic in Brazil

Abstract

Objective

The aim of the study was to assess the impact of the COVID-19 pandemic on sales of modern contraceptive methods in Brazil.

Methods

Monthly sales data were analysed of short-acting reversible contraceptive methods and long-acting reversible contraceptive (LARC) methods (implants and intrauterine contraception) and COVID-19 related deaths. Contraceptive methods were grouped as follows: emergency contraception (EC); oral contraception, vaginal rings and transdermal patches; injectable contraception; LARC methods including the copper intrauterine device (Cu-IUD); and LARC methods excluding the Cu-IUD.

Results

Contraceptive sales showed a non-significant increase in 2020 compared with the previous year; average sales ranged from 12.8 to 13.0 million units per month. Sales of injectable contraceptives increased between March and June 2020 and EC pills between June and July 2020; the variation in sales of pills, patches and rings was not significant. Sales of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the etonogestrel (ENG) implant showed three patterns: a decrease in sales between February and May 2020 (coinciding with the closure of family planning services), an increase in sales after May 2020 (coinciding with the first COVID-19-related deaths), and a further increase in sales after July 2020 (corresponding to the increasing number of deaths from COVID-19).

Conclusion

The COVID-19 pandemic has disrupted the Brazilian health care system. Since many family planning clinics were closed, sales of most modern contraceptives fell during 2020; however, the increase in sales of the LNG-IUS and ENG implant in the private sector indicates inequitable access to modern contraceptive methods.

摘要

目的：评估COVID-19大流行对巴西现代避孕方法销售的影响。

方法：对短期可逆避孕方法和长期可逆避孕（LARC）方法（植入剂和宫内避孕）的月销售数据及COVID-19相关死亡病例进行了分析。避孕方法分组如下：紧急避孕( EC )；口服避孕药、阴道环和经皮贴剂；避孕针；LARC方法包括铜宫内节育器( Cu- IUD )；以及除Cu- IUD之外的LARC法。

结果：与上年相比, 2020年避孕用品的销售增长不显著；平均销售量为每月12.8 ∼ 13.0万。2020年3∼6月避孕针销售增多, 2020年6 ∼ 7月EC销售增加；口服药、经皮凝胶和阴道环的销售量变化不显著。左炔诺孕酮宫内缓释系统( LNG-IUS )和依托孕烯植入剂( ENG )植入剂的销售呈现三种模式：2020年2月至5月销售减少（与计划生育门诊关停相对应）, 2020年5月后销售增加（与第一例 COVID-19相关死亡相对应）, 2020年7月后销售进一步增加（与 COVID-19死亡人数的增加相对应）。

结论： COVID-19 的流行破坏了巴西的卫生保健体系。由于许多计划生育诊所的关闭, 大多数现代避孕方法的销售在2020年下降；然而, 私立医院的LNG-IUS和ENG植入剂销售量增加表明现代避孕方法的获取不均等。

Keywords:

• Brazil
• modern contraceptive methods
• COVID-19
• LARC
• SARC
• SARS-CoV-2
• unplanned pregnancy

Acknowledgements

We acknowledge the help of IQVIA PMB (São Paulo, Brazil) for providing most of the data used in the study.

Disclosure statement

LB has served on medical advisory boards and given ad hoc invited lectures for Merck and Bayer. The other authors report no conflicts of interest.

Additional information

Funding

The study received partial financial support from the Fundação de Apoio à Pesquisa do Estado de São Paulo [FAPESP; award no. 2015/20504‐9] and from the Brazilian National Research Council [CNPq; grant no. 573747/2008‐3]. CMC and AM received funding from SRH, part of the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, a co-sponsored programme executed by the WHO, to complete their postgraduate studies. The institutions which provided financial support for the conduct of this research did not participate in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. This article represents the views of the named authors only and does not represent the views of the mentioned organisations.