Birth control is always a controversial issue in the United States. It is all the more remarkable how little background noise the national drug agency FDA announced a groundbreaking decision on Thursday: For the first time in the country’s history, the agency approved a contraceptive pill that can be sold without a prescription. The significance of this decision is enormous in a country where nearly half of pregnancies are unplanned, according to the FDA.
The drug is called Opill and is manufactured by Perrigo Company, based in Dublin, Ireland. According to the company, the pill will be available in the United States from early 2024. What is probably the most important point has not yet been determined: how much the pill should cost.
About 30 million Americans have no health insurance. This has meant that millions of women of childbearing age have not had access to birth control pills because they cannot afford the visits to the doctor needed to get a prescription. Private visits to the doctor are sometimes absurdly expensive in the USA. It is one of the great mysteries of life in the United States that such a wealthy country maintains such an unfair health care system that leaves almost ten percent of the population unprotected.
Since the Supreme Court ruled last year to overturn the nationwide legal right to abortion, many Republican-governed states have made access to abortions, in some cases massively, more difficult. In some states, abortion is only legal up to the sixth week. At this point, many women do not yet know that they are pregnant. Other Republican-governed states are expected to follow suit.
As a result of the Supreme Court’s decision, many advocacy groups have stepped up efforts to provide access to over-the-counter birth control pills, including the American Medical Association, the Association of Obstetrics and Gynecologists, and the Academy of Family Physicians.
In May this year, a commission of independent FDA consultants met to consider the pros and cons of releasing the drug Opill. They came to the unanimous verdict that the benefits of the release far outweighed the disadvantages. The FDA has now followed this recommendation.
Vice President of Women’s Health at Perrigo, Frederique Welgryn, released a statement saying the company wants to make sure the pill is “available and affordable” for women of all ages. In addition, an aid program is planned that will make the pill available to some women free of charge.
Like so much in the US, it will ultimately be a question of money. The Kaiser Family Foundation (KFF), a non-partisan organization specializing in health surveys, found in a survey that ten percent of eligible women were unable or unwilling to pay for the pill. About 40 percent would be willing to pay $10 or less for a monthly ration. Another 30 percent set the upper limit at $20 a month. This is an extremely small sum considering the usual cost of medicines in the country.
The Affordable Care Act, passed by Barack Obama’s administration, requires insurance companies to cover the cost of prescription contraceptives. However, over-the-counter remedies are exempt. That could change under Joe Biden’s government given the new situation. However, it is not certain, since every law in Congress is bitterly disputed between Democrats and Republicans.
Should the over-the-counter pill become widely available and affordable in the United States by 2024, it could have a significant impact, especially when it comes to unwanted teenage pregnancies. KFF’s survey also revealed that, unsurprisingly, the over-the-counter pill would be used especially by women without health insurance. According to its own statements, the manufacturer Perrigo intends to announce what the drug will cost in the fall.