Photo by Sarah Pflug at Burst
WASHINGTON, DC (April 14, 2020)—Making a progestin-only pill (POP) available over the counter (OTC)—i.e., without a prescription—could increase access to contraception. POPs, which do not contain the estrogen found in other oral contraceptives, have few contraindications, so they may be the first oral contraceptive available on an OTC basis. Women’s interest in using an OTC POP suggests that making this option available with no out-of-pocket cost could reduce U.S. unintended pregnancies by eight percent, found the authors of a new study published today in Women’s Health Issues.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Alexandra Wollum, of Ibis Reproductive Health, and her co-authors used data from a survey of 2,539 U.S. women aged 15 to 44 to model use of OTC POP at different levels of monthly out-of-pocket cost. They found that 12.5 million adult women and more than 1.75 million young women aged 15-17 would be willing to use an OTC POP if it were free to them. Those numbers dropped to 7.1 million and 760,000, respectively, when the price increased to $15. The authors’ models indicated that these levels of use would translate to an estimated 8 percent decrease in unintended pregnancies (approximately 320,000 fewer) in one year among adult women when cost-sharing was $0 and the typical-use failure rate of an OTC oral contraceptive was 9%, and a 5 percent decrease (approximately 199,000 fewer unintended pregnancies) at a monthly out-of-pocket cost of $15.
“Our analysis shows that affordability and insurance coverage for an OTC POP are key to ensuring that populations, especially low-income people, who may lack access to more effective methods and would prefer to switch, are able to afford and access the product,” Wollum and colleagues wrote. “Policymakers should work to pass laws requiring insurance to cover OTC contraceptives and advocates and decision makers should urge pharmaceutical companies to sell an OTC POP at a price affordable to those with a range of incomes.”
“As the COVID-19 pandemic causes more challenges to health care access and exacerbates existing inequities, it’s essential to find ways to reduce barriers to contraception,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and Associate Professor of Prevention and Community Health at Milken Institute SPH. “This study provides important evidence of the potential impact of making progestin-only pills available over the counter.”
“Modeling the Impacts of Price of an Over-the-Counter Progestin-Only Pill on Use and Unintended Pregnancy among U.S. Women” has been published online as an article in press and will appear in the May/June issue of Women’s Health Issues.