Today’s Solutions: April 12, 2024

Opill, the first over-the-counter birth control pill in the United States, is poised to change the landscape of contraceptive access. It is a progestin-only contraceptive pill and boasts an impressive 98 percent efficacy rate in preventing pregnancy, as substantiated by data submitted to the U.S. Food and Drug Administration. 

Conveniently, it can be procured through online platforms and will soon hit the shelves of major retailers including CVS, Walgreens, Target, and Walmart, offering widespread accessibility to consumers across the nation. Individuals will be able to receive birth control without a prescription via Opill, similar to how common drugs such as Tylenol or aspirin may be obtained. Dr. Jonas Swartz, an OB-GYN at Duke Health, emphasized the importance of this breakthrough, saying, “This is a big win for reproductive health care access.”

Over-the-counter access: taking down barriers

Dr. Swartz hails Opill as a huge achievement for reproductive health care access, citing the elimination of unnecessary barriers to obtaining a prescription. “As physicians, we don’t need to be the gatekeepers to contraception, and I think [Opill] removes that gate in a really meaningful way,” he said.

Dana Singiser, co-founder of the Contraception Access Initiative, agrees with Swartz, describing over-the-counter access as a “pivotal milestone” in the face of rising abortion restrictions. “As abortion bans are being passed across the country, it is even more important for people to be empowered to not get pregnant if that’s what they want,” Singiser said.

Filling gaps: addressing unmet needs

Opill is positioned to fill major gaps in contraception access, particularly among underserved groups. Dr. Swartz emphasizes the potential impact of over-the-counter contraception in rural areas with provider shortages, where traditional treatment may be limited. He goes on to say, “It’s a real shame to lose access to contraception completely in that gap.”

Beyond the doctor’s office: pharmacist-prescribed contraception

Contraception is accessible outside typical healthcare settings to community pharmacies, where Opill is predicted to be widely distributed. Mollie Scott, regional assistant dean at the UNC Eshelman School of Pharmacy, emphasized the need for pharmacists to deliver complete contraceptive counseling and customized care. “I can see a woman coming into the pharmacy, and the pharmacist can have the conversation with her about [Opill] and other options,” Scott said.

The road to affordable access: challenges and solutions

While Opill represents a huge advancement in contraception access, price remains a major barrier. Singiser supports federal laws that require insurance coverage for over-the-counter contraception, which aligns with public opinion and legislative actions aiming at increasing fair access to birth control. She underlines the significance of tackling affordability obstacles for Opill to have the greatest impact on boosting contraceptive availability nationwide.

Singiser emphasizes the importance of resolving affordability concerns, particularly among vulnerable communities. “The $20 price for a one-month supply will be out of reach for some folks,” she said. 

According to KFF’s 2022 Women’s Health Survey, there is significant variation in the affordability barrier for over-the-counter oral contraception. Only 16 percent of respondents indicated a willingness to pay more than $20 per month, while 39 percent were OK with a monthly expenditure of $1-10. Alarmingly, 11 percent said they were unable or unwilling to pay for over-the-counter contraception. In response to these concerns, Perrigo, the maker of Opill, has announced plans for a cost-assistance program that will help qualified low-income and uninsured persons obtain Opill at a reduced or no cost.

However, while federal regulation requires coverage for FDA-approved contraception with a prescription, there is a significant gap in coverage for nonprescription contraception. Singiser lobbies for policy changes to address the discrepancy. She stresses the illogical discrepancy in which prescription contraception is covered yet over-the-counter methods are disregarded. Singiser emphasizes the importance of a unified government policy requiring insurance coverage for over-the-counter contraception, which aligns with the majority of Americans who support increased access to birth control. Legislative initiatives are underway to solve this issue, with the goal of not only stocking shelves with contraceptives but also making them affordable to all persons in need.

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