Getting the Pill OTC?

After spending the past year listening to Catholic spokesmen attacking health care laws that provide funding for birth control, I’m curious to see their reaction to this article from the LA Times:

The American College of Obstetricians and Gynecologists issued a call Tuesday for birth control pills to be sold over the counter. Currently oral contraceptives are available only with a doctor’s prescription.

In a policy statement, the organization argues that making birth control pills easier to get will translate into fewer unwanted pregnancies. These unplanned pregnancies remain a major problem in the United States, they write, accounting for approximately 50% of all pregnancies. And such pregnancies, they argue, do not just interrupt lives — they also cost a fortune, with a price tag of approximately $11.1 billion per year, according to an analysis published in the academic journal Perspectives on Sexual and Reproductive Health.

According to the obstetricians and gynecologists, one major reason women at risk for unintended pregnancies don’t use birth control is that they don’t have regular access to a doctor, either for practical reasons or because they are uninsured. And in a 2004 telephone survey conducted by an Oakland based nonprofit, 47% of the uninsured women who currently do not use birth control say they would use it if it were available over the counter, like Tylenol or Benadryl. Another recent survey, conducted by public health experts in Texas, found that 60% of women not on birth control pills would use it if they could buy it without a prescription. Such statistics, they argue, make plain the need to increase access. [...]

One issue that the group concedes is a real hurdle is the potential for increased costs. Currently, birth control is covered by health insurance; whether that would continue if the pills were available over the counter is unclear.

Very interesting. The one thing I’m worried about is the potential for blood clots, but I’m assuming that other people have already considered the risk of that. I know that many women have adverse reactions to the pill – one women complained about three weeks of bad PMS – but as the College suggests those women can monitor themselves.

  • FO

    What are the adverse effects of the pill?

    Also, I would expect that farma companies are inflating the price to exploit government support.
    Is this possible in the US?
    Would selling them over the counter force the companies to reduce the prices?

    Could the greater volumes sold also decrease the prices?

    • J-Rex

      Mood swings, irregular periods, lower libido, headaches, weight gain, and nausea.

      • Stedman Fan

        Not to mention stroke, heart attack, high blood pressure and so forth.

        But who cares as long as women keep their naked pussies available to a man whenever he needs to relieve himself in it?

    • kenneth

      OTC prices always drop the price, sooner or later. I’ve been taking a particular antihistimine since it came out in the 80s. When I first got it as a prescription drug, it cost $3 a pill. It’s been OTC now for some years and now it’s about 3 cents a pill! In the short run, people can pay more out of pocket than with good insurance, but very few of us anymore have the kind of insurance that covers all drugs with a $3 co-pay.

      The Catholic Bishops no doubt will try to fight this tooth and nail. They have tried to end contraceptive access for all people, even with prescription.

  • machintelligence

    Generally OTC drugs are cheaper than prescription drugs. Prilosec, for example, once only available by prescription for treating ulcers, is now available OTC for treating gastric reflux (heartburn). The cost for a 20 mg. tablet is about $1.40 by prescription and $.55 OTC. Of course, almost no one has stomach ulcers anymore, since they have identified the bacterium that causes them and treat the infection rather than the symptoms. Almost like magic, they found a new (or at least popular) use for this “powerful prescription only” drug and now sell it OTC.

  • Artor

    My ex started using the pill as a teenager, but had the wrong dosage for her metabolism. As an ignorant teenager with insufficient knowledge of how her body was supposed to work, she ended up bleeding non-stop for several months before she collapsed from severe anemia. While I agree that making the pill available OTC is a good thing, I hope there will be some mechanism to avoid serious errors like this.

    • FO

      Did she receive any sex ed?
      How’s it possible that she didn’t even tell her parents?
      You must live a very repressed life if you can’t tell to your parents that you have been BLEEDING FOR WEEKS!

      • Mogg

        I’m not sure that I would have. I would have read the instructions, though, and gone to the school nurse for advice – I was fortunate enough to go to a hifh school that had one. Caveat: I was on the Pill at 14, but not for contreception so it was “okay”. Still incredibly embarrassing to me that anyone other than my mother knew, but if I hadn’t had the “okay” excuse that I got violently ill with every period, there’s no way even my mother would have known. I knew someone who went to a strange doctor for a gynaecological treatment because she was too worried that her Christian family doctor would break patient confidentiality laws and tell her parents if she went to him for treatment. Repression of that sort is not thst uncommon in fundie circles.

  • J-Rex

    I think this could be a really good idea, but they would need to educate people about this a lot more. They have other risky medications available OTC, but generally you don’t plan on taking those for months or years at a time.
    Maybe they should have someone sit down with them and go over the information and make sure they’re aware of how to take it and what could go wrong. When my sister started taking the pill, she thought she was just supposed to take one after each time she had sex. She didn’t get pregnant, thankfully, but this is information that she really should have known and the person prescribing it to her should have made sure she understood.
    They should also make sure people know that if one pill doesn’t work for you, another type might. Many women don’t realize this, so they’ll either stick with the pill they’re on even though it’s bad for them, or they’ll give up on pills completely.

    • vasaroti

      There also needs to be education about how to dispose of unused pills properly. While we justifiably fret about hormones fed to livestock, our meds are having weird effects on fish and other wildlife.

    • FO

      This is utterly retarded…. O_O
      Don’t the meds come with instructions, even the OTC ones!?
      My ex gf got loads of info about everything she needed to do, and this was like 15 years ago in Italy!

  • Noelle

    Huh. It’ll take more than ACOG recommending it to get it on the shelves. But it’s an idea. As mentioned already, it’d take some education on how to use them, what to do if you miss a pill, what it won’t prevent, potential adverse reactions, etc. The most common side effects are things you feel: nausea, headaches, mood changes, decreased libido. The more serious adverse reactions are more rare and trickier for a non-medical person to detect: HTN, elevated liver enzymes, strokes, blood clots. One gets these and more side effects with pregnancy too, so most would consider OCP’s a good option for contraception. But I’d feel a lot better about it if women actually had access to health care professionals who could teach and monitor them. A lot of people have a false sense of security with OTC meds, when many could hurt or kill you if taken inappropriately.

    As for the other question, making an Rx med available OTC does seem to bring down the price eventually. In the last several years, antihistamines and anti reflux meds have gotten less expensive both OTC and Rx-wise.

    • kenneth

      We tend to look at this question as though we have only two binary choices: Prescription drug or OTC with no education or oversight at all. The people who could really make a viable third option are pharmacists. We tend to think of them as cashiers with a fancy diploma whose only real value is to spot any deadly interactions before they happen. In reality, their training is every bit as comprehensive in its own way as physicians, and their knowledge of medications is vastly superior to that of MDs. If birth control pills were sold from behind the counter, even without a prescription, there would be an opportunity to have important questions answered.

      • Noelle

        If pharmacists are given the time to do it, that’s not a bad way to go. Most retail pharmacists are swamped, especially in the large chains. They also can’t provide exams and testing when something doesn’t go as planned. Mid-level providers, like PA’s, Nurse Practitioners, and Nurse midwives are also good resources.

        As to who has a wider knowledge of medication, well that depends on what you’re looking at. If you’re talking half-life, chemistry, mechanism, compounding, med interactions, and other stuff one learns in a PharmD program, then yes, a pharmacist generally does know more. If you’re speaking of practice and keeping up to date on how physicians in each field use different meds, then I’d go with the doc. How and why certain meds find themselves used off-label is one example. Balancing the ever-changing recommendations from different expert groups is another place. A practicing physician is a sort of artist-scientist, and some of the information they’re privvy to may come from a different source than the PharmD’s training.

  • Noelle

    Here’s an article on how a prescription med can be reclassified as OTC, for those who like to know the specifics. It’s 14 years old, but I don’t believe anything’s changed since then. It’s a time-consuming process and often done by a drug company trying to extend its patent. ACOG can give it’s opinion, but that doesn’t mean a drug company will jump through the FDA hoops.

    It needs a school house rock song for the full effect, but I couldn’t find that.