Doctors react to possibility of over-the-counter birth control

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Doctors react to possibility of over-the-counter birth control

Dr Daniel Grossman

Doctors may soon play a much smaller role in prescribing contraceptives, and many agree with the reduced role.

In July, HRA Pharma applied to the Food and Drug Administration to sell a progestin-based birth control pill without a prescription in retail pharmacies.

“The fact that this pill is so safe, with such a short list of contraindications, is a no-brainer to determine whether or not they are eligible,” Daniel Grossman, MD, director of the Promotion of new standards in reproductive health program at the University of California, San Francisco, he said.

Progestin-only birth control pills have fewer potential risks for women with specific health risks, such as heart conditions. containing estrogen Birth control is associated with the risk of blood clots.

Roughly 112 countries had some form of over-the-counter access to oral contraceptives in 2015, according to a 2019 analysis published in BMJ Global Health.

Doctors react to possibility of over-the-counter birth control

Dr. Melissa Kottke

“Accessing contraceptives without a prescription could be a game changer for people who experience common barriers to accessing clinics,” said Melissa Kottke, MD, an associate professor in the Department of Obstetrics and Gynecology at Emory University in Atlanta, Georgia. “For example, this can help people who can’t get an appointment for several months, who don’t have a doctor nearby for care, who can’t leave work or school to get to a clinic appointment, who do not have transportation, they need additional privacy, [or] who prefer to self-manage their contraception. In expansion contraceptive access is particularly important in a political landscape that is increasingly restrictive of reproductive rights.”

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the American College of Obstetricians and Gynecologiststhe American Medical Associationand the American Academy of Family Physicians have expressed support for birth control pills being available without a prescription.


Grossman said that while HRA Pharma’s product, Opill, would provide women with an additional birth control option, it should not replace doctor-patient interactions or consultations about contraception.

Some doctors worry that over-the-counter pills aren’t reaching the patients who need them most. Pharmacy and health care deserts disproportionately affect black and Hispanic women, according to Ebony Jade Hilton, MD, an anesthesiologist at the University of Virginia, Charlottesville.

“As we discuss more things being offered over the counter — COVID-19, medications, birth control — can we really build those counters in Black and Latino communities?” Hilton wrote on Twitter. “We have hospital and pharmacy deserts. Options mean nothing without access.”

Hilton also said that over-the-counter contraceptives should be affordable.

“For patients who face the most barriers to accessing care, the only way OTC birth control will make a difference for them is if it’s available at an affordable price,” Hilton said.

Grossman said he expects the FDA’s decision to be controversial, as it was when the agency approved Plan B for emergency contraception for birth control in retail establishments.

“In the beginning there was a age restriction put on emergency contraception when he was being considered for an over-the-counter switch,” Grossman said. “He ended up taking a lawsuit for the product to be fully available”.

Grossman is a senior adviser to Ibis Reproductive Health, a Boston-area nonprofit that has been running a campaign involving more than 100 reproductive health advocates and related groups. IBIS partnered with HRA Pharma in 2016 to help conduct studies for application to the FDA.

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