Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

It’s time to make oral contraceptives available without a prescription

Jeffrey A. Singer, MD
Meds
January 2, 2018
Share
Tweet
Share

STAT_Logo

At his recent confirmation hearing, Alex Azar, President Trump’s nominee for secretary of Health and Human Services, was grilled by senators who wanted to know where he stands on requiring employers to provide oral contraception coverage in their employee health plans — even if employers object on religious or moral grounds. While avoiding specifics, Azar committed himself to finding a balance between making contraceptives affordable and available to women, and respecting “the conscience of their employers.”

Lost in the back and forth was the opportunity to ask Azar if he would press the Food and Drug Administration to let the U.S. join the 102 countries that currently allow birth control pills to be sold over the counter without a prescription.

The American College of Obstetricians and Gynecologists (ACOG) has called for making birth control pills available without a prescription for many years; its Committee on Gynecologic Practice reiterated that opinion in 2012. The American Academy of Family Physicians agrees. And a 2015 survey of nearly 500 reproductive health care providers found that 74 percent of them supported expanding access to oral contraceptives.

In response to concerns that women may forgo necessary preventive care visits if birth control pills are available over the counter, ACOG states that “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating OC [oral contraceptive] use and should not be used as barriers to access.” In fact, there is currently a debate among gynecologists regarding the need and benefits of annual pap exams.

Another worry has been that women may misuse oral contraceptives without pre-screening by a health care professional. But OTC advocates point to a 2006 report from Seattle showing women’s self-evaluation regarding whether or not they should take the pill matched those of doctors about 90 percent of the time — and the 10 percent of the time they didn’t match was mostly because the women erred on the side of caution.

In light of this medical consensus, it is patronizing to still require women to get an exam and what amounts to a permission slip from a health care practitioner in order to get oral contraceptives. Men certainly don’t have to get a men’s wellness exam and a prescription for condoms.

The prescription status of birth control pills also places a financial burden on women. Leaving work or home to wait in a doctor’s office for a prescription costs time and money.

Several states have tried to work around the FDA’s prescription classification by allowing pharmacists to prescribe birth control pills. While that’s an improvement over the status quo, it still negatively affects women’s comfort and privacy. As shown in a 2015 report in the journal Sexual and Reproductive Healthcare, many women who seek emergency contraception (the so-called morning after pill, which has been available over-the-counter since 2006) prefer to purchase this kind of medication discreetly and avoid unwanted discussion or counseling, even if offered by a health care professional.

The obstacles created by the prescription status of oral contraceptives may be one reason why many women stop taking them after just one year. Removing these obstacles may help women take oral contraceptives longer and thus prevent unwanted pregnancies. In its 2012 call to reclassify birth control pills as nonprescription drugs, ACOG cites research from the University of Texas that compared the use of oral contraceptives across the U.S.-Mexico border at El Paso/Ciudad Juarez — oral contraceptives are available over the counter in Mexico. The researchers concluded that providing users of oral contraceptive pills “with more pill packs and removing the prescription requirement would both lead to increased continuation.”

Finally, prices of oral contraceptives, which currently average between $20 to $50 per month but range as low as $9 per month, might come down further once they can be sold over the counter and are rendered vulnerable to greater competition and consumer scrutiny.

According to FDA regulations, a petition to reclassify a drug from prescription to nonprescription/over-the-counter status can come from a manufacturer, any “interested party,” or the FDA commissioner. Congress can also legislate reclassification.

With heath care costs continuing to climb, with many people living paycheck to paycheck, and with the health care professions united in their call to make oral contraceptives available without a prescription, it is lamentable that the senators questioning Azar at his confirmation hearing didn’t dive into this matter. If he’s confirmed, I hope he will do the right thing and lift this burden off of millions of American women.

Jeffrey A. Singer is a general surgeon. This article originally appeared in STAT News.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

After #MeToo, have the rules changed?

January 2, 2018 Kevin 57
…
Next

Why are so many doctors doing multi-level marketing?

January 3, 2018 Kevin 0
…

Tagged as: OB/GYN, Public Health & Policy

Post navigation

< Previous Post
After #MeToo, have the rules changed?
Next Post >
Why are so many doctors doing multi-level marketing?

ADVERTISEMENT

More by Jeffrey A. Singer, MD

  • The FDA’s outdated prescription rules are failing women and opioid users

    Jeffrey A. Singer, MD
  • We need a new Hippocratic Oath that puts patient autonomy first

    Jeffrey A. Singer, MD

Related Posts

  • Oral health is justice for all

    Richard Rodriguez, DDS
  • It’s time for a comprehensive universal health care system in America

    Sagar Chapagain, MD
  • It’s time we think about health care differently

    Praveen Suthrum
  • a desk with keyboard and ipad with the kevinmd logo

    Now is the time to eliminate tuition in the health sciences

    Thomas Schroeder
  • It is time for stewardship of our health insurance system

    Jenna Holmen, MD
  • It is time to make a dent in social determinants of health

    Joe Nicholson, DO

More in Meds

  • Tofacitinib: a lesson in heart-immune health

    Larry Kaskel, MD
  • The case for regulating, not banning, kratom

    Heidi Sykora, DNP, RN
  • How India-Pakistan tensions could break America’s generic drug pipeline

    Adwait Chafale
  • The unfair war on buprenorphine

    Brian Lynch, MD
  • Drug giants face suit over hidden cancer risks

    Martha Rosenberg
  • The diseconomics of scale: How Indian pharma’s race to scale backfires on U.S. patients

    Adwait Chafale
  • Most Popular

  • Past Week

    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • The high cost of PCSK9 inhibitors like Repatha

      Larry Kaskel, MD | Conditions
    • The decline of the doctor-patient relationship

      William Lynes, MD | Physician
    • Rethinking cholesterol and atherosclerosis

      Larry Kaskel, MD | Conditions
    • Diagnosing the epidemic of U.S. violence

      Brian Lynch, MD | Physician
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The mental health workforce is collapsing

      Ronke Lawal | Conditions
    • A doctor’s struggle with burnout and boundaries

      Humeira Badsha, MD | Physician
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
  • Recent Posts

    • Expanding Parkinson’s care: a new universe for patients, caregivers, and clinicians [PODCAST]

      The Podcast by KevinMD | Podcast
    • How health disparities affect children

      Ronald L. Lindsay, MD | Physician
    • Rethinking cholesterol and atherosclerosis

      Larry Kaskel, MD | Conditions
    • Why doctors need emotional skills to survive

      Robin Stern, PhD and Marc Brackett, PhD | Conditions
    • Stepping down in medicine: Why letting go can be an act of leadership [PODCAST]

      The Podcast by KevinMD | Podcast
    • Celebrating internal medicine through our human connections with patients

      American College of Physicians | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • The high cost of PCSK9 inhibitors like Repatha

      Larry Kaskel, MD | Conditions
    • The decline of the doctor-patient relationship

      William Lynes, MD | Physician
    • Rethinking cholesterol and atherosclerosis

      Larry Kaskel, MD | Conditions
    • Diagnosing the epidemic of U.S. violence

      Brian Lynch, MD | Physician
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Rethinking the JUPITER trial and statin safety

      Larry Kaskel, MD | Conditions
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The mental health workforce is collapsing

      Ronke Lawal | Conditions
    • A doctor’s struggle with burnout and boundaries

      Humeira Badsha, MD | Physician
    • The stoic cure for modern anxiety

      Osmund Agbo, MD | Physician
  • Recent Posts

    • Expanding Parkinson’s care: a new universe for patients, caregivers, and clinicians [PODCAST]

      The Podcast by KevinMD | Podcast
    • How health disparities affect children

      Ronald L. Lindsay, MD | Physician
    • Rethinking cholesterol and atherosclerosis

      Larry Kaskel, MD | Conditions
    • Why doctors need emotional skills to survive

      Robin Stern, PhD and Marc Brackett, PhD | Conditions
    • Stepping down in medicine: Why letting go can be an act of leadership [PODCAST]

      The Podcast by KevinMD | Podcast
    • Celebrating internal medicine through our human connections with patients

      American College of Physicians | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...