FDA makes right call on birth control pills
The FDA this month approved over-the-counter sales of the contraceptive, Opill, which has been in use for over a half-century. Credit: Perrigo
More than six decades after birth control pills were approved for use, women will soon be able to purchase them without a doctor's prescription. By early next year, one brand of oral contraceptive should be universally available online, in vending machines, and at local convenience stores. This long-delayed approach — more than 100 nations don't require a doctor's approval --- to easing access to a pill which can prevent pregnancy when properly used comes at an especially fraught time for women and their ability to control their reproductive choices.
Earlier this month, the FDA approved over-the-counter sales of the progestin-only contraceptive, Opill, which has been in use for over a half-century. The agency is still reviewing applications for similar over-the-counter sales of a pill that combines estrogen and progestin. The push to allow access to safe and effective hormonal pills without obtaining a prescription from a physician has been ongoing for years, but the FDA's decision came only after the Supreme Court overturned Roe v. Wade in 2022, allowing states to ban or severely restrict access to abortion.
There are over three million unplanned pregnancies each year in the U.S. and some research suggests that easier access to birth control pills will lead more women to use them and stay on them longer. One in four women ages 15 to 44 use the pill and 30% of first births occur among teenagers.
There is more to be done, however, if we truly want to reduce unwanted pregnancies and abortions. Over-the-counter sales must be low-priced and covered by insurance without the need for a prescription which is already the case in New York and a handful of other states. The Senate is considering a national mandate but that's unlikely to move forward in the House because of Republican opposition. The Biden administration is exploring whether this can be accomplished by executive order.
Ease of access and affordability are critical public health issues.
One concern is that sexually transmitted diseases and cervical cancer will go undetected because women will not regularly be examined by a doctor or get a Pap smear. But the answer to that worry is to increase primary gynecological care, which is not readily available in some states, not restrict easy access to contraception.
The FDA regulation does not restrict purchase of the pills by age and critics say earlier sexual intercourse could increase pregnancies if very young girls don't understand the need to take the pills every day. But that is a social concern beyond the FDA's requirement to ensure a drug is safe. If there are consequences, and data indicates there is a problem, the age limits could be revisited.
No drugs are totally safe; even aspirin can have side effects. More reproductive rights battles are ahead, but this one on the birth control pill is a solid win.
MEMBERS OF THE EDITORIAL BOARD are experienced journalists who offer reasoned opinions, based on facts, to encourage informed debate about the issues facing our community.
