The first over-the-counter birth control pill has been approved by the FDA. What will it cost?
An over-the-counter birth control pill will be available to Americans for the first time early next year — but it’s not yet clear what it will cost or if insurance will cover it.
The progestin-only pill known as Opill received federal approval Thursday and will be sold in retail pharmacies in early 2024. When taken daily at the same time, the pill is incredibly effective in preventing pregnancy.
But though the pill’s manufacturer, Perrigo, has said it wants to make the pill “accessible and affordable” to the general public, the company has not yet said what the drug will cost. Frederique Welgryn, Perrigo’s global vice president for women’s health, said that price information will be available in the coming months.
Under the Affordable Care Act, private health insurance plans must cover one method of each form of birth control without charging consumers any out-of-pocket costs, but plans can require that the patient receive a prescription for the medication first. Spokespeople for Perrigo said the company is in talks with private insurance and Medicaid programs, but said that as they understand it, the current law does not appear to require coverage of the over-the-counter pill. That would mean that barring a policy change, those who use the drug would have to pay the yet-undetermined price themselves.
“Today, over-the-counter [drugs] are not covered by private insurance. It would need a change of law to make sure this would be the case,” Welgryn said. “Right now, I think we have some work to do to make that happen.”
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Out-of-pocket costs greater than $10 can substantially deter people from getting medication, especially for Black women and Latinas, who on average earn far less than White women, Powers noted.
Polling from KFF suggests that interest in using an over-the-counter form of hormonal birth control is similar among low-income and higher-income people. Those who lack any form of health insurance appear more likely than those with coverage to say they would use it: 1 in 4 uninsured women between the ages of 18 and 49 expressed interest, compared to about 1 in 5 of those with private insurance.
Reproductive health advocates, many of whom pushed for Opill’s approval, said that they intend to work with lawmakers both in the Biden administration and Congress to prioritize insurance coverage for the new pill. The administration recently put out an executive order meant to expand access to contraception, including a directive that the secretaries of Treasury, Labor and Health and Human Services consider what could be done to expand access to over-the-counter contraception. Those same departments have been asked to examine whether to put out new guidance ensuring that private insurance covers federally approved contraception.
“It’s obviously critically important that insurance covers an over-the-counter pill to make sure that everybody who wants can use it and doesn’t lose what we have now,” said Kelly Blanchard, president of Ibis Reproductive Health, a research organization that has supported making an over-the-counter pill available.