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The Pill should be over-the-counter

BY DI EDITORIAL BOARD | NOVEMBER 30, 2012 6:30 AM

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Last week, the American College of Obstetricians and Gynecologists released its December 2012 Committee Opinion encouraging the over-the-counter sale of oral contraceptives.

The opinion cited the consistently high rates of unintended pregnancies in the United States as a primary reason for wanting to increase women’s accessibility to the birth-control pill, which is easily the most popular form of contraception, especially among college-age women.

The birth-control pill should be switched to an over-the-counter drug, but efforts must focus on keeping the costs low so that all women will be able to access this important family-planning medication.

Selling the pill without a prescription does not alone make it more accessible. In fact, the Journal of Managed Care Pharmacy reported that for several drugs switched from prescription-only to over-the-counter, many consumers experienced higher out-of-pocket health-care costs.

The report examined the increased costs of allergy medicines such as Nasalcrom, as well as other medications, including Vagistat, Nizoral and Lamisil. In evaluating the economic effects, the report concluded that “the combined effect of increased out-of-pocket medical expenses and out-of-pocket drug costs contributed to higher out-of-pocket health-care costs for all categories of consumers.”

This was especially evident for patients who received their coverage from Medicaid, who may have seen costs increase by as much as 113 percent after their prescriptions became available over the counter.

“I’m generally in favor of anything that makes birth control more accessible to more people,” said Linda Kroon, the director of the Women’s Resource and Action Center. “My preference would be to see it both prescribed and over the counter so that people who rely on insurance would not be hurt by the switch.”

The economic effects are especially important in regards to this topic. Nearly 50 percent of all pregnancies in the United States are unintended, and this has been the case at least since 1995, according to the Centers for Disease Control and Prevention. Though women of all income levels may have unintended pregnancies, low-income women are more likely to become pregnant unintentionally.

While switching birth control from a prescription may mean losing insurance coverage and increasing costs of the pill, eliminating the often unnecessary cost of visiting a doctor could help to bring costs down.

“Taking the pill is safer than being pregnant,” said Ann Laros, a staff gynecologist for the University of Iowa Student Health Service and member of the American College of Obstetricians and Gynecologists. “I would like to encourage all people to continue with regular health-care maintenance, but I think birth control is safe and should be more accessible.”

In fact, Laros explained, often the greatest risk relating to oral contraceptives is the chance of developing a blood clot. However, that risk is increased substantially for women who become pregnant and is far higher for women who have delivered a child, according to a recent study from the U.S. Food and Drug Administration.

Allowing the birth-control pill to be sold over the counter could seriously increase the health of women and children in Iowa and throughout the United States.

“We don’t make men have a prostate exam before they can buy condoms,” Laros said. “Birth control is as safe as Tylenol.”


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