Oral contraceptives over-the-counter: Reinforcing the importance of insurance coverage
New research from Ibis and the University of California, San Francisco found that insurance coverage of a future over-the-counter (OTC) birth control pill would result in more widespread use by women and would be cost effective to health insurance plans. In recent years, there has been growing interest in the possibility of making regular birth control pills available without a prescription. During last year's midterm elections, several Republican candidates announced their support for OTC birth control pills, though it is often assumed that a future OTC oral contraceptive would not be covered by insurance. However, our new study published in the journal Contraception finds that use of an OTC birth control pill would be highest among low-income women--and would therefore have the biggest impact on unintended pregnancy--if it were fully covered by insurance.
Using data from published surveys on contraceptive use and women's interest in an OTC pill, researchers estimated that if the pill were fully covered by insurance, there would be an increase of 11%-21% in the number of low-income women using the birth control pill. Most of those new users would be previous users of a birth control method less effective than the pill or women using no method at all, resulting in a reduction of unintended pregnancy by 7%-25%.
The study builds on previous research indicating that women's interest in using a future OTC pill is highly correlated with its cost. Under the Affordable Care Act, most women with insurance are able to obtain contraception without co-pays or deductibles. Dr. Dan Grossman, a co-author on the study, said, "In the era of no-co-pay contraception, there is still a need for over-the-counter birth control to fill the gap when women run out of pills while traveling, for example, or for those who find it inconvenient to get to a clinic. But to reach the largest number of women most in need, it's critical that a future OTC pill be covered by insurance."