Big Wild Card on New Birth Control Pill: The Cost

It's a milestone day in terms of reproductive health care: The FDA cleared the way for the first over-the-counter birth control pill to be sold. Which means at some point in early 2024, anyone will be able to walk into a store and buy the daily oral contraceptive—called Opill and made by the Irish company Perrigo—without a doctor's prescription. Coverage:

• Fewer accidents: Advocates have been pushing for such an option for decades, arguing that the hurdle of having to see a doctor—the cost, having to take time off from work, etc.—has meant that many women (particularly younger women and those with low incomes) have gone without birth control as a result. In its announcement, the FDA notes that approximately half of all pregnancies in the US are unintended.
• The cost: Perrigo has not fixed a price yet, and advocates for women's health say the cost will be a huge factor in determining how much of a help the drug will be. Vox notes that studies have shown a price as low as $10 can result in people skipping needed medicine. "It is clearly a huge priority for the reproductive health community to make sure that the on-the-shelf price truly is affordable for the consumers who tend to have less access to health care," Dana Singiser of Contraceptive Access Initiative tells the New York Times.

• The cost, II: As USA Today notes, insurance typically doesn't cover OTC drugs. However, President Biden already has directed federal agencies to figure out coverage in consultation with insurers, employers, and pharmacists, per Vox. The safest bet would be a congressional requirement mandating insurance coverage, though the prospects of that happening are uncertain.
• The pill: STAT News notes that Opill has only the hormone progestin, unlike other contraceptive pills that have a combination of progestin and estrogen. As such, it's known as a "mini pill," though it is just as effective as preventing pregnancies. "Women with more medical conditions would be precluded from taking combination pills, which can cause depression, among other things," per STAT. "But progestin-only pills have downsides, including reduced effectiveness if they are not taken at the same time daily."
• Not new: Opill is not a new drug and was, in fact, approved for use in the US decades ago—though only with a prescription. "It's been around a long time and we have a large amount of data supporting that this pill is safe and effective for over-the-counter use," Kelly Blanchard of the nonprofit Ibis Reproductive Health tells USA Today.

(More birth control stories.)