Could OTC Birth Control Be Coming to Pharmacies Soon?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
Posted on

Regular birth control pills are already available over-the-counter in many countries including China, Greece, India, Turkey, Mexico, South Africa, Russia, and Korea. In the U.S., we are slowly but surely starting to provide women with greater access to birth control products without requiring a prescription.

In 2013, Plan B One-Step, the emergency contraceptive that can prevent pregnancy, was made available without a prescription (“over-the-counter” or OTC) without an ID or age restriction.

This was a step in the right direction for the over-the-counter approval of other birth control products (the pill many women take monthly, for example). Why is this? Plan B One-Step contains levonorgestrel, the same hormone used in many birth controls—just at a higher dose.

How can a medication like birth control become available without a prescription?

Over-the-counter (OTC) medications are drugs that are considered safe and effective for use by the general public—without the requirement that you seek treatment from a health care professional.

In the past several years, many drugs have made the transition from prescription-only to being readily available over-the-counter in your pharmacy and grocery store medication aisles.

In order for a medication to be available over-the-counter, it must meet a few requirements. First and foremost, it must be easy to use—that is, you have to be able to self-diagnose and decide you need the medication, with little to no negative effects.

The Federal Food, Drug, and Cosmetic Act of 1938 requires all new drugs to be found safe before they go on the market. Changing a previously prescription-only drug to make it available over-the-counter is no different.

OTC medications must also have clear and concise labeling, so you know how to take the medication properly. In 1997, the FDA created rules for the labeling of OTC products, making them standardized and easier to understand and read.

Is there anywhere in the US I can get birth control pills without a prescription now?

In Oregon and California, and in some Washington state pharmacies, women can get access to birth control just by visiting their local pharmacy.

In these states, birth control pills do not yet truly have over-the-counter status, but there is no need to go to the doctor to get or renew a prescription. A short-questionnaire and consultation with your pharmacist will have you out the door in no time with oral contraceptive in hand.

Many other states like Tennessee and Missouri are following suit by creating and/or passing bills allowing women greater access to birth control pills by allowing the pharmacist to essentially prescribe and dispense the medication.

Are there any drawbacks to pharmacist-prescribed birth control?

Some have expressed concern that not requiring women to have an annual checkup could mean that some skip important tests and screenings.

A Pap test is recommended every 3 or 5 years for most women ages 21 to 65. Pharmacists cannot write a prescription for a woman who is unable to provide evidence that she has visited a women’s health provider within 3 years of the pharmacist’s initial prescription for a contraceptive.

However, some birth control advocates believe that pharmacist-prescribed birth control still limits access for women because of the age restrictions in some states, and the requirement in some states that women see a doctor every few years.

What type of birth control pill could be available without a prescription?

One pharmaceutical company, HRA Pharma, is researching a progestin-only pill that could be the first OTC oral contraceptive.

HRA Pharma is a French Pharmaceutical company that is collaborating with Ibis Reproductive Health to conduct the research necessary to get birth control over-the-counter.

Are there advantages to a progestin-only pill?

Progestin-only birth control pills present the fewest barriers for the most people.

First, progestin-only pills are not associated with the increased risk of high blood pressure or cardiovascular disease that can be an issue with some other birth control medications. They can also be used if you have some health conditions that would normally prevent you from taking a birth control pill—for example, uncontrolled high blood pressure or deep vein thrombosis.

They also don’t interfere with sex, can reduce menstrual bleeding or stop your period altogether, and can be used after child-birth even if you are breast feeding.

Bottom line?

The possibility of birth control without a prescription may become a reality in the near future.

Drugs featured in this story

Filed under