Center for American Progress

The First Over-the-Counter Birth Control Pill Marks a Pivotal Moment in Birth Control Access

The First Over-the-Counter Birth Control Pill Marks a Pivotal Moment in Birth Control Access

The first over-the-counter birth control pill will soon be available on shelves at retailers nationwide; we must ensure it is affordable and accessible to everyone.

Members of Congress support legislation that would protect birth control access.
Members of Congress support legislation that would protect birth control access during a press conference outside the U.S. Capitol in Washington, D.C., on June 14, 2023. (Getty/AFP/Saul Loeb)

Today, drug manufacturer Perrigo announced that Opill will be on shelves at retailers nationwide in the coming weeks and is available now for pre-order online at select online retailers. For the first time in U.S. history, a daily hormonal birth control pill will be available for purchase over the counter (OTC) without a prescription at in-person and online retailers across the country. This announcement comes eight months after the U.S. Food and Drug Administration (FDA) approved Opill for over-the-counter sale with no age restrictions. This is a monumental day for reproductive health, rights, and justice that has been decades in the making. Everyone deserves to have access to the full range of safe and effective birth control options, and today’s announcement is a victory for the health of women and girls across the country.

What is Opill?

Opill is a daily hormonal birth control pill used to prevent a pregnancy before it starts. It is a progestin-only pill, which is also known as a “minipill.” This type of pill was approved for prescription use more than 50 years ago by the FDA.

OTC birth control supports women’s reproductive and bodily autonomy

Nearly all women of reproductive age will use some form of contraception over the course of their lifetimes. As such, it is absolutely essential that every woman and all people who can become pregnant have access to affordable contraception that responds to their individual needs and helps meet their family planning goals without unnecessary barriers. However, use of and access to family planning services varies considerably, often with the most marginalized women facing access and affordability barriers at nearly every step in the process. In particular, young people; women with disabilities; women with low incomes; women living in rural areas and areas with health care provider shortages; and women of color may have a harder time accessing contraceptive care.

OTC birth control helps alleviate barriers to care and mitigate access challenges

Opill’s emergence as the first OTC birth control pill is pivotal for accessibility and has the potential to reshape the landscape of family planning care by mitigating some of those key barriers and providing individuals with greater autonomy over their reproductive choices. Traditionally, access to hormonal birth control has been dependent on access to health insurance and to a regular health care provider who could prescribe it. OTC coverage of contraceptives would help eliminate the need for people to first get a prescription from a physician, reducing logistical burdens and other barriers such as scheduling appointments, taking time off work, travel time, and arranging child care. This shift to nonprescription OTC status holds immense promise for ensuring that everyone—regardless of their social identities, socioeconomic status, health insurance status, or geographic location—can access contraception and exercise reproductive choice.

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Ongoing efforts are needed to ensure comprehensive contraceptive care and reproductive health for all

However, Opill is not a panacea for the persistent and pervasive barriers that exist for high-quality and equitable health care. Reproductive rights advocates and leaders have fought for decades to secure and improve options for birth control alongside the necessary resources and conditions for adequate care and sustainability. Comprehensive sex education, affordable health care overall, and dismantling systemic inequities in care are also required in order to truly remove barriers to contraceptive use. Policy and funding decisions must work in conjunction with these issues in order to truly support equitable access and affordability for all people. In January 2024, reproductive health leaders called on Perrigo and retailers to set Opill’s retail price at $15 for a three-month supply to ensure it is affordable for everyone and to develop a robust assistance program to support people who are unable to pay the retail price. The suggested retail price of $19.99 for a one-month pack is a good starting point, but more must be done to ensure the pill is affordable and accessible to all who need it, including insurance coverage and assistance programs.

Things you need to know about Opill

Where can I get Opill?

Opill will be available at major retailers and pharmacies as well as select online retailers in the coming weeks. It is available for pre-order now on the Opill website. To see if it is available near you, visit

Is Opill covered by insurance?

As of August 2023, six states—California, Maryland, New Jersey, New Mexico, New York, and Washington—have passed laws requiring state-regulated private insurers to cover OTC contraception without a prescription and without cost sharing. Additionally, seven states use state-only funds to cover certain OTC contraceptives for Medicaid enrollees. A federal requirement for insurers to cover OTC contraceptives without cost sharing and without a prescription would help close the gaps that exist between states and across the country. Uniform coverage of OTC preventive services through federal regulation would help prevent confusion about coverage requirements for consumers, health plans, retailers, and providers.

Perrigo also announced that Opill may be eligible to be paid through flexible spending or health savings accounts, but availability is subject to the specific benefits of the person’s health plan.

Do I need a prescription to buy Opill?

Opill will be available for over-the-counter purchase at pharmacy counters and other retailers nationwide. This means that anyone—including young people—can walk into their local pharmacy and select retailers and get birth control. The online option also provides another meaningful avenue for access. Traditionally, access to hormonal birth control has been dependent on access to health insurance and to a regular health care provider who could prescribe it, so this shift means that people without insurance or regular health care can have a wider range of effective options available to them.

What is the price of Opill?

The manufacturer’s suggested retail price (MSRP) is $19.99 for a one-month supply and $49.99 for a three-month supply. Additionally, Opill will be available for purchase online at a price of $49.99 for a three-month supply and $89.99 for a six-month supply. Each retailer has discretion to adhere to that pricing. Perrigo also announced that it is working on a cost-assistance program in the coming weeks to help low-income, uninsured, and underinsured people get Opill at low or no cost.

Is Opill safe for teens?

On July 13, 2023, the FDA approved Opill for sale over the counter with no age restrictions. Research demonstrates that Opill is generally safe for most people who could get pregnant, including people as young as 15. There is no evidence to suggest that safety or side effects are different in adolescents compared with adults.


OTC birth control pills are available in more than 100 countries in the world, and Americans can now celebrate finally joining that growing list. But policymakers must continue to innovate in order to bridge gaps and push reproductive health forward. The coming months will be a litmus test not just for Opill but for setting a precedent for future advancements in and improvements to contraceptive care and access. Policymakers, health care professionals, and advocates must work together to ensure the promise of Opill is fully recognized and to ensure it reaches individuals across diverse communities by requiring insurance coverage of Opill without a prescription.

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Kierra B. Jones

Senior Policy Analyst


Women’s Initiative

The Women’s Initiative develops robust, progressive policies and solutions to ensure all women can participate in the economy and live healthy, productive lives.

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