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Over-the-counter access to oral contraceptives as a reproductive healthcare strategy

Grossman, Daniela,b; Fuentes, Lizaa

Current Opinion in Obstetrics and Gynecology: December 2013 - Volume 25 - Issue 6 - p 500–505
doi: 10.1097/GCO.0000000000000019

Purpose of review The aim of this review is to summarize the current evidence on the safety and effectiveness of moving oral contraceptives from prescription-only to over-the-counter (OTC) status. The review also examines women's interest in OTC access to oral contraceptives, as well as potential barriers and facilitators to an OTC switch.

Recent findings Studies show that women can safely self-screen for contraindications to oral contraceptives – especially progestin-only pills – without the aid of a clinician. One study in Texas found that women using pills obtained OTC in Mexico were significantly less likely to discontinue compared to women obtaining pills at US clinics by prescription. A national representative survey of US women at risk of unintended pregnancy found widespread interest in using OTC pills, and many women worldwide already have access to pills without a prescription. On average, the most US women report being willing to pay for an OTC pill is $20.

Summary OTC access to oral contraceptives could help to reduce unintended pregnancy by increasing the number of pill users, improve continuation and reduce gaps in use. It is critical that a future OTC pill be made available at an accessible price, and it should be covered by insurance without a prescription. Research suggests that common concerns about the safety of oral contraceptives OTC and a potential negative effect on women's use of preventive services are largely unsupported.

aIbis Reproductive Health, Oakland

bBixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA

Correspondence to Daniel Grossman, MD, Ibis Reproductive Health, 1330 Broadway, Ste 1100, Oakland, CA 94612, USA. Tel: +1 510 986 8941; fax: +1 510 986 8960; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins