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Everything you need to know about the new over-the-counter birth control pill coming to retailers

Opill, the first oral contraceptive available without a prescription, is a safe and effective method for preventing pregnancy, experts say.

A three month pack of Opill with sleeves of pills.
Opill, the first over-the-counter daily oral contraceptive, is a safe way to help more people access birth control says one Northeastern expert. Photo by Perrigo Company

After approval from the Food and Drug Administration last summer, Opill, a daily oral contraceptive, is now coming to retailers, making it the first birth control pill available without a prescription.

Perrigo Co. announced on March 4 that Opill shipped to major retailers and should be available in-store and online in the coming weeks.

“I think it’s fabulous,” said Kathy Simmonds, a clinical professor in nursing at Northeastern University who has worked for years in the reproductive health space. “The more ways that we make birth control (and) hormonal contraception accessible in the places where people live and work, the more they’re able to have autonomy and control over their reproductive destiny.”

Headshot of Kathy Simmonds.
Nursing professor Kathy Simmonds said the new over-the-counter birth control pill can help people overcome barriers to getting contraceptives. Courtesy photo

Previously, patients needed a prescription to access hormonal birth control. But getting to a  doctor’s office presented hurdles for rural populations, teens trying to avoid the stigma of using birth control or just for busy caretakers who didn’t have time for an appointment, Simmonds said. Opill, which is available online and in retailers, can remove some of these obstacles and allow people safe access to hormonal birth control.

Some birth control pills can pose health risks for users, particularly blood clots. But Opill is “super safe,” according to Simmonds who currently works in rural health through the Roux Institute of Northeastern University. Opill only contains progestin, a synhetic form of the hormone, progesterone, which controls the menstrual cycle, creating a cervical mucus to prevent sperm from getting into the upper reproductive tract. This pill creates progestin in the body throughout the cycle.

“It’s an evolutionary strategy that our bodies have used, but now pharmaceuticals have found that that’s a way to prevent pregnancy,” Simmonds said. “It has a safety profile that is unbeatable. It doesn’t cause blood clots and really anybody can take it.”

Other types of pills contain estrogen, the hormone that thickens the uterine lining before the period. While these pills carry a lot of benefits, they can cause blood clots, something Opill does not do, making it a safe option (and a highly effective one when it comes to preventing pregnancy), she said.

Opill is more likely to cause spotting in between periods. It also can’t help with cycle control or ease PMS symptoms or hormonal acne. (Some people take birth control pills for these reasons.)

The FDA approved Opill for prescription use in 1973, about 13 years after the first oral contraceptives were approved for prescription use in 1960. Since then, oral contraceptives have become the most commonly used reversible form of contraception, according to the Kaiser Family Foundation.

Birth control pills have a failure rate of less than 1% if taken every day, but Kaiser found more than one-third of women from 18 to 49 missed a dose because they weren’t able to get their next supply in time. The same survey found 77% of women from 18 to 64 favored making birth control pills available over the counter without a prescription, with 40% of these women saying they’d likely use this type of pill if it was safe and effective, citing convenience as a factor.

While Opill’s over-the-counter availability is a huge step forward for birth control access, Simmonds said it’s “a double-edged sword” when it comes to cost. Opill is sold at $19.99 for a one-month pack and $49.99 for a three-month pack. Six-month packs are available online for $89.99.

However, Simmonds said this cost can still be prohibitive for some, unless insurance plans begin covering the cost of Opill.

“That’s not cheap for some people,” she added. “Under the Affordable Care Act, methods of contraception should be covered. It’s challenging for some people if it’s an over-the-counter method. This is still getting worked out.”

Despite the kinks being worked out with cost, Simmonds said Opill’s availability overall is a huge win. She said someone in an abusive relationship, teens or anyone who is busy can benefit from having easy access to a highly effective hormonal pill such as this.

“The more places that we can create access … the better,” said Simmonds. “Just because it’s over the counter doesn’t mean somebody can’t also still consult with a health care provider in person or over telehealth. Being able to not have that extra step of having to go to a clinician’s office for a visit, really lowers some of the barriers for people.”