Policy Brief Pushes for OTC Birth Control

Making birth control available OTC would improve women’s access to oral contraceptives while producing dramatic cost savings, a new National Center for Policy Analysis (NCPA) brief argues.

Beginning in January 2016, pharmacists in Oregon will be authorized to dispense transdermal and oral contraceptives without a prescription to women 18 years and older.

At the federal level, Senators Kelly Ayotte (R-NH) and Cory Gardner (R-CO) have introduced Senate Bill 1438, the “Allowing Greater Access to Safe and Effective Contraception Act,” which would permit oral contraceptives to be sold OTC nationally.

The concept has wide-scale support. A May 2015 survey by Ibis Reproductive Health found that more than 50% of respondents, including health care providers and academic researchers, were “strongly in favor” of OTC birth control, while 86% were either “strongly in favor” or “somewhat in favor.”

Planned Parenthood and the American College of Obstetricians and Gynecologists (ACOG) also support the idea of OTC birth control, but they oppose S. 1438 because the proposal does not include cost-reduction measures and it narrowly refers to the birth control pill.

To address their latter point, ACOG and Planned Parenthood argued that long-acting reversible contraceptives such as intrauterine devices (IUDs) are the most effective contraceptives. By providing OTC oral contraceptives, they asserted, women will wind up paying more for less-effective forms of birth control.

Yet, recent estimates from the US Centers for Disease Control and Prevention show that women already prefer birth control pills over long-acting reversible contraceptives. CDC data from 2011 to 2013 suggest that 16% of women using a contraceptive method take the pill, which is more than double the 7.2% of women with long-acting reversible contraceptives.

In terms of costs, ACOG and Planned Parenthood noted that S. 1438 would eliminate the no-co-pay contraceptive mandate of the Affordable Care Act, which they believe would make contraceptives unaffordable for millions of women.

However, the NCPA pointed out, transitioning birth control to OTC would lower prices precipitously and result in dramatic cost savings, as was seen when proton pump inhibitors made the jump from prescription to OTC. Additionally, estimates from the Consumer Healthcare Products Association suggest that consumers save between $6 and $7 in prescription costs in unnecessary physician visits for every $1 spent on an OTC product.

Given that 54,000 pharmacies in the United States offer prescription drug services, while 700,000 retail outlets sell OTC products, S. 1438 would greatly improve access to birth control for the 7 million US women who use oral contraceptives, the NCPA concluded.