Imagine picking up your birth control at the pharmacy or grocery store whenever you need it—without worrying about a prescription or taking off a few hours from work to make an appointment with your gyno. Sounds fantastic, right? It's a premise that reproductive rights groups have been considering for years, and it's recently been cast into the spotlight again with several Republican candidates supporting it.
But here's the thing: OTC birth control probably wouldn't be as simple and carefree as you think.
"Over-the-counter birth control is an important concept," says Vanessa Cullins, M.D., vice president of external medical affairs at Planned Parenthood Federation of America. "It is another vehicle to increase access to contraception. It should not be the only vehicle, and most definitely—just as it's stated in the Affordable Care Act legislation—contraception should still be available without a copay."
See, the current Affordable Care Act birth control benefit allows women to receive any FDA-approved contraceptive method without a copay, as long as they have a prescription. What many politicians are supporting is a system where birth control comes out onto the store shelves to be more convenient, but it likely wouldn't be covered at no cost.
The OTC Debate
The reason some politicians are in favor of this is that it seems to be a compromise to the birth control mandate. If birth control was available over the counter, insurance companies wouldn't have to cover the full cost and employers wouldn't have to worry about covering it if they had an objection. As we saw with the Supreme Court decision in favor of Hobby Lobby, not everyone is in favor of covering all birth control methods without a copay, so putting it over the counter would be a way to shift the responsibility and the payment to each individual who wants protection.
There's no doubt that making birth control over the counter would be more convenient in certain situations—like when you accidentally run out of refills and need them ASAP or when you want to start the Pill but don't have time to schedule a gyno appointment.
That said, it could also create a barrier for women who can't afford birth control if the cost goes up (Cullins says there's no way of knowing at this time how much OTC birth control might cost). Unfortunately, more than half of women ages 18-35 report struggling with the cost of birth control at some point, causing them to use it inconsistently, according to a survey by Planned Parenthood.
Then, of course, there's the matter of what methods would even be available over the counter. Obviously, anything that needs to be inserted, like the IUD or implant, would not be available on a drugstore shelf. The birth control pill, the ring, and the patch could potentially be sold over the counter, as long as they meet all of the FDA criteria, says Cullins (this includes making sure people can understand the label, that they can determine whether or not they're an appropriate candidate for that particular drug, that it cannot be addictive, etc.).
Plus, if birth control became available over the counter, the OTC options for women would be more limited than what's currently covered under the Affordable Care Act. "There are well over 40 formulations of birth control pills," says Cullins, and each of those usually has a branded version and at least one generic. "So not every formulation will go over the counter."
This also means you would still need a prescription for the IUD, which is over 99 percent effective and the method used most by physicians. Sure, OTC pills would be more convenient, but with a failure rate of about nine percent with typical use, they're not the most foolproof method out there.
So while this plan sounds like a simple fix at first, it may mean paying more money for more limited and less effective birth control methods. It could even result in women going for the cheapest or most convenient option, when that might not be what's actually best for her individual needs.
"There are no magic bullets," says Cullins. "No one birth control method tends to serve one woman throughout her entire reproductive life. Women will try different methods to see what works best for them and under which circumstances." But if some methods become OTC while others are available with a prescription and a copay, it might mean even more confusion for women just trying to find the right contraception for them.
MORE: 7 Crazy, Mind-Blowing Facts About the Pill
What the Future of OTC Birth Control Looks Like
Perhaps the biggest problem with this debate is that politicians really can't control what medications are available where. "Congress cannot make any type of medication go over the counter," says Cullins. "That is a decision made in this country by the FDA and it is accompanied by research that is conducted by pharmaceutical companies." But get this: "As of now, there is no pharmaceutical company that has expressed concrete interest in taking [their method over the counter]," says Cullins.
For now, it's highly unlikely that any forms of birth control will be available without a prescription in the near future. "I've been involved with groups that have been discussing this for the past 10 years," says Cullins. "Given that, it really is safe to say it's going to be several years. There are additional studies that need to be done."
MORE: What if Buying Condoms Was as Much of a Process as Buying Birth Control?
That's certainly not for lack of support for increased access. In one recent poll, 70 percent of Americans said they were in favor of over-the-counter birth control. And previously, the American College of Obstetricians and Gynecologists (ACOG) stated that oral contraceptives are safe enough for OTC availability.
"The hope is that we would have coexistence of over-the-counter methods and pills and other contraceptive methods that are covered by insurance without a copay," says Cullins. "But we don’t know what the future will bring considering how charged this issue is."
In the meantime, stay informed about your contraceptive options and the latest news by visiting our birth control center.
MORE: 10 Birth Control Myths—Debunked
Powered by WPeMatico
No comments:
Post a Comment