Over-the-counter (OTC) birth control pills: Improving access and reducing barriers

What providers should know about over-the-counter birth control pills

There are a few key points clinicians should keep in mind when discussing or recommending OTC birth control to their patients.

It reduces barriers to access

A study on access to prescription birth control revealed that about one-third of adult American women who have attempted to acquire prescription contraception have faced access barriers. Although the Affordable Care Act has addressed some of these issues, the study suggests that there may still be other factors that need to be tackled to improve access to contraception.

The key benefit of OTC birth control is the way it addresses healthcare access for patients who might have challenges. 11% of women in general report not having a personal doctor and the number is as high as 25% for Hispanic women. Additionally, one third of American women report facing access barriers when trying to obtain prescription access to contraception.

At a cost starting at $19.99 for a one-month pack, OTC birth control could be more affordable for many patients, especially considering they do not have to factor in the cost of a doctor’s visit or challenges in scheduling an appointment.

By eliminating the need for a prescription, OTC birth control pills can provide a reliable and convenient option for women who might not otherwise have access to contraception. This includes women who live in rural areas with limited access to healthcare, as well as those who may face barriers to accessing care due to cost or other factors.

In addition to the cost and time required to obtain a prescription, many women face other barriers to accessing care, such as transportation or time off work. This can make it difficult for them to obtain the contraception they need, which can lead to unintended pregnancies and other negative health outcomes.

Consumers can accurately assess their needs

According to a survey conducted in 2022 by KFF, a healthcare research organization, over 75% of women of reproductive age expressed their preference for an OTC pill. The primary reason for this preference was convenience.

Your patients are generally well-equipped to manage use of OTC birth control, including screening for contraindications. This has been proved in the past by a study of women between the ages of 19 and 49 using a medical checklist. Clinicians can support their patients in creating and using checklists customized to their goals in preventing unintended pregnancies. (Example of a self-screening checklist)

It’s effective

Norgestrel and drospirenone are effective when used correctly and while larger studies from real use situations are needed to confirm this, they approach the efficacy of the traditional estrogen-progestin combined contraceptives.

Norgestrel’s perfect use effectiveness rate is as high as 98% (according to the manufacturer), but use of hepatic enzyme-inducing drugs can reduce effectiveness.

It has broad support from the medical community

Dozens of medical organizations have supported the use of over-the-counter birth control without age restrictions, including:

• American College of Obstetricians & Gynecologists
• National Hispanic Medical Association
• American Academy of Nursing
• National Association of Pediatric Nurse Practitioners
• American Academy of Pediatrics

Much of the world already has access

OTC contraception has been available outside the United States for years and is currently available in more than 100 countries, most commonly in Latin America, Africa, and Europe. Until now, the U.S. has lagged as one of the few countries that did not have at least one OTC birth control option.

The role of providers in navigating over-the-counter birth control pills

As healthcare professionals, we have the opportunity to help individuals achieve their reproductive goals and have healthy outcomes. Providing education about the benefits and risks of OTC birth control pills, as well as other contraceptive options, lets patients make informed decisions that meet their needs. This also includes providing guidance on how to use OTC birth control pills correctly and consistently.

Patients who have access to OTC birth control pills may be more likely to use contraception consistently and correctly than those who need a prescription. This can support improved patient control of if, and when, to become pregnant, which can improve health outcomes for the pregnant patient and baby.

Improving the quality of contraceptive services, which need to be rights-based and patient-centered, requires addressing knowledge gaps and biases among healthcare workers. The role of healthcare workers in providing family planning services, including counseling and prescribing contraception, is critical. However, personal biases can hinder a provider’s ability to support informed choice for their patients. It is crucial to understand the counseling and prescribing practices of health workers as well as their personal values and preferences towards contraception. By improving and standardizing education and training globally, we can ensure high-quality contraceptive services that are patient-centered, involve shared decision-making, and promote reproductive autonomy.

The future the provider role in OTC birth control

Clinicians will have growing opportunities to act as guides for their patients in answering reproductive healthcare questions and having culturally sensitive conversations about norgestrel as part of a complete plan for preventing unwanted pregnancies. These conversations can help improve medication adherence and patient understanding.

Effective conversations should be enabled by culturally sensitive technologies and content that aligns with the goals and demographics of your patient mix.