Paying Cash For Your Birth Control? Here’s How to Save

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Thirty percent of women who use contraception in the United States use oral contraceptives. Add to this women who use birth control pills for other medical conditions (polycystic ovary syndrome, heavy menstrual periods, ovarian cysts, etc) and imagine the number of women who may now be forced to pay cash for these medications.

On June 30th the Supreme Court decided that for-profit companies cannot be compelled to provide insurance coverage for contraception if doing so violates the religious beliefs of the company’s owners.

Regardless of how you feel about this decision, there is no question many women will now be paying out of pocket for their pills. Going forward, here is what you need to know.

You, alone or with your doctor, can compare the cash price of your birth control pills at pharmacies in your area with and agree on the cheapest identical pill. Often the pill you are taking now has a cheaper identical option. You should never be paying more than $40 a month. Let me show you five things:

1.  Can I just change my pill to a generic one?
First, know the dose of estrogen in the pill you are taking. There are many ultra-low-dose estrogen and low-dose estrogen pills and you need to care about this because if you are taking a brand name oral contraceptive you need to know there are many identical generic options. Yes, you can switch.

2.  With the popular ultra low dose estrogen pills, what are some generic equivalents?

The brand name Alesse with 0.02 mg ethinyl estradiol, has many identical options. If your pill costs more than 30 dollars a month now, look for the generic identical pill with the same exact levels of hormones. Alesse, Aviane, Lessina, Lutera and Orsythia are the same medication. Goodrx shows you in the margin all the identical options you may choose from. Run it by your doctor to change your prescription if they agree, or the pharmacist can request this change from your doctor.

3.  Next up, the low dose estrogen pills.

Pills containing 0.02mg – 0.035mg of estrogen are in this class. Again, plug in the name of your pill in to Goodrx and often there is an equivalent that will save you quite a bit of money each month. Some examples here are Ortho-Cept and Desogen which are brand name identical medications with many generic equivalents like Apri, Reclipsen, and Solia. Seasonale (brand name) and its popular generic Jolessa will vary quite a bit in price.

4.  Now, saving money on Triphasic pills (a different dose every week of the cycle).
Cyclessa is a brand name whereas Velivet is an identical/cheaper option. Ortho-Novum 7/7/7 has Necon 7/7/7 and Cyclafem 7/7/7 as popular generic options. A quick note here: studies show women who used Cyclessa had significantly less breakthrough bleeding or spotting and experienced an average weight loss of 4 pounds versus an average weight gain of 2 pounds with those who took Ortho-Novum 7/7/7. Just sayin’.

5.  The newer pills with a different type of progestin.
Yasmin and Yaz are low dose birth control pills but they have a different type of progestin from the other pills, called drospirenone. Look up generic options like Ocella and Zarah for Yasmin.

Many of you in my office are paying way too much for your pills. Now that paying cash may be a reality for you, take charge, compare prices on Goodrx and save money on something you shouldn’t be paying for anyway.

Dr O.

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