For the first time, women in the US can walk into a store and buy a supply of birth control pills right off the shelf, without the need for a prescription or health insurance.
Opill, the first oral contraceptive approved by the US Food and Drug Administration for over-the-counter use, has arrived at most stores in certain retail pharmacy chains such as CVS, Walgreens and Walmart.
The product “is now available at CVS.com and through the CVS Pharmacy app and is arriving at more than 7,500 CVS Pharmacy stores in the coming weeks,” spokesperson Matt Blanchette said in an email. “For added privacy and convenience, customers will be able to choose same-day delivery or buy online and pick-up in store.”
Walgreens began offering Opill in late March, spokesperson Samantha Stansberry said.
The product “will be available at Walgreens nationwide in the family planning aisle and behind the pharmacy,” Stansberry said in an email. “Customers can also purchase the product online for 30-minute Pickup, 1-hour Delivery, or ship to home.”
At Walmart, “it is currently available on walmart.com and will be in stores in early April,” spokesperson Tricia Moriarty said in an email.
In early March, the first shipments of Opill were sent to distributors, major drug stores and pharmacies – but as those shipments made their way through the distribution pipeline, it took days or weeks before customers were able to get their hands on the product.
That timeline includes shipments arriving at distribution sites and then being delivered to retailers. Retailers then either package the product for online orders or place it on store shelves.
Opill has a suggested retail price of $19.99 for a one-month supply and $49.99 for a three-month supply, and at Opill.com, a six-month supply will be available for $89.99. For consumers with health insurance plans that include FSA or HSA accounts, Opill may be eligible to cover with those funds, but individual plans can vary, according to Perrigo, the company behind Opill.
A survey conducted by the nonprofit KFF in 2022 found that among women who said they were likely to use over-the-counter birth control pills, 39% said they were willing and able to pay up to $10 per month for them, 34% would be willing and able to pay up to $20 per month – the recommended cost of a one-month pack of Opill – and only about 16% said they would pay more than $20. Under the Affordable Care Act, most insurance plans are required to offer coverage of birth control with no out-of-pocket cost, so it is free.
Last week, Perrigo launched a cost assistance program to provide Opill at reduced or no cost for consumers who are not able to afford the product. To be eligible for the program, a customer must not have commercial or government-provided public insurance, must have a household income at or below 200% of the Federal Poverty Level and must live in the United States or a US territory.
Some advocacy groups applauded the program.
“As the first over-the-counter birth control pill, Opill, hits store shelves, it’s critical to ensure that those who face the greatest barriers to sexual and reproductive health care do not face financial barriers to accessing Opill,” Dr. Raegan McDonald-Mosley, CEO of Power to Decide, a nonprofit that focuses on sexual and reproductive health, said in a statement.
“This cost assistance program is an important step towards increasing access to contraception for those in need,” she said. “With this assistance, eligible individuals can get months’ worth of birth control at no cost, allowing them to take control of their sexual and reproductive health care without worrying about the cost.”
Opill was approved by the FDA without age restrictions and is “suitable for most people of reproductive age to use to prevent pregnancy,” according to its website. Opill works as a “mini-pill,” using only the hormone progestin to prevent pregnancy. It’s a different formulation than what is in combination hormonal birth control pills, which contain both progestin and estrogen.
Combined birth control pills may carry risks for people with uncontrolled hypertension or blood clot risks for smokers older than 35. Contraindications for progestin-only pills include conditions such as breast cancer or liver disease, or the use of certain medications.
When taken as directed at the same time every day, Opill has been found to be 98% effective at preventing pregnancy, according to Perrigo. Most birth control pills are up to 99% effective at preventing pregnancy if taken as instructed every day.
“For people who are trying to decide whether Opill is the birth control pill they want to try, I think the main things that I would talk to them about is making sure first that they are the kind of person who wants to take a pill every day,” Dr. Colleen Denny, director of family planning at NYU Langone Hospital-Brooklyn, said Monday.
“The second thing that I often talk to them about is the main noticeable side effect with Opill, which is just changes in people’s periods,” she said. “About half of people have irregular bleeding. It’s not dangerous. It’s not a side effect that is worrisome, but it can be bothersome.”
Essentially, the milestone of Opill availability gives the patient control over when they would like to start or stop taking a daily birth control pill, Denny said.
“You don’t need to take time out of your life to get a prescription. You don’t have to have a doctor who’s established. You don’t have to take time off to go to a doctor’s appointment or get there or get to the pharmacy during their prescription-dispensing hours, none of that. And likewise, when you’re ready to stop taking the birth control pill, you just stop,” Denny said.
“What’s special about Opill is that it’s really very patient-centered,” she said. “They have a lot of control over all aspects of taking this medicine that is sort of a new thing in the United States.”