Contraceptive Technology Innovation
Why invest in contraceptive technology innovation?
While the existing contraceptive method mix includes highly effective options, an estimated 214 million women in low- and middle-income countries still have unmet need for family planning. To address this gap, contraceptive technology innovation is needed to do several things:
- Identify more targeted approaches and novel delivery systems
- Refine existing products to reduce side effects and increase user acceptability
- Implement creative strategies to introduce and scale up underused products
- Method mix: The breadth of contraceptive products available in a locale.
- Modern method: A product or medical procedure that interferes with reproduction resulting from acts of sexual intercourse
- Multi-purpose prevention technologies: A class of products (films, gels, intravaginal rings, etc.) that deliver concurrent protection from pregnancy, HIV, and/or sexually transmitted infections.
- Underused technology: Method not available in a country’s reproductive health program, despite its presence in a comparable country’s program.
In an ideal world, women would be able to choose whether, when, and how often to have children. An expansive arsenal of contraceptive options would be available to them as their priorities switch between delaying pregnancy, spacing children, and limiting family size. Unfortunately, for millions in need, current family planning methods are unacceptable, unaffordable, or inaccessible.
While contraceptive technology innovation is needed to broaden the method mix, developing the next best family planning option is a daunting task. It can easily take 15 years to move a new contraceptive innovation from the discovery phase and early clinical research through clinical trials and regulatory approval to country registration and product introduction.
Investment in contraceptive technology research is needed on multiple fronts:
Method acceptability: Behavioral research needs to be conducted in parallel with early development efforts to ensure that preferences of potential users are incorporated into product design. Method acceptability data could also inform product introduction messaging strategies.
Refinement of hormonal products for women: Hormonal contraceptives are highly effective at preventing pregnancy. However, real and perceived side effects lead to discontinuation and non-use. Further evaluation of dose levels and development of new delivery systems could improve side effect profiles for some of these methods.
Adding on-demand options to the method mix: A large percentage of women do not use hormonal methods because they do not have sex frequently. Novel non-hormonal technologies that provide short-term, switch on/switch off pregnancy protection could fill this gap in the method mix.
Developing multi-purpose prevention technologies (MPT): In areas with high incidence of HIV, MPTs could provide protection from both pregnancy and HIV. The same approach is being used to develop methods that concurrently prevent pregnancy and other sexually transmitted infections.
Identifying non-hormonal male contraceptive targets: While male hormonal contraceptive research has had recent clinical setbacks, discovery efforts that target sperm development and motility are providing new insights into reproductive biology and may clear a novel pathway for a non-hormonal male contraceptive.
Exploring new self-administered delivery systems: The need for discretion and a preference for self-administration are driving the development and scale-up of new delivery systems, such as the single-dose Uniject (already available in certain markets as Sayana Press®) and microneedle patches (still in the early research phase).
Increasing availability of products: The introduction of new or underused products gives couples more options and helps to keep the marketplace price-competitive. Investments in contraceptive research must be made in tandem with the scale-up of existing products in new geographies.
Like all therapeutic areas, contraception is an evolving science, with research and development efforts moving new and improved technologies forward. Continued investment in contraceptive technology innovation will enable people worldwide to choose from a broad selection of family planning methods to meet their changing needs.