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

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.

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.

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.

Conclusion

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.