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Without a prescription, insurance may not cover the birth control pill Opill


For the first time in US history, the Food and Drug Administration authorized a birth control pill for use without a prescription this week.
According to Perrigo, Opill will be accessible in major retailers and online in early 2024.

Women may find difficulties obtaining Opill because birth control without a prescription is not currently mandated by health insurance.
Because health insurance companies are not mandated to cover the medicine in its over-the-counter version, the first birth control pill available without a prescription in the United States may stay out of reach for certain women and girls.


The FDA approved the sale of the oral contraceptive Opill without a prescription on Thursday, a historic move that should make birth control pills more accessible by eliminating the need to visit a doctor’s office and renew prescriptions.

According to a 2016 poll published in the Journal of Women’s Health, one-third of adult women who have ever attempted to acquire prescription contraception have encountered difficulties to access.


Perrigo is the maker of Opill.

The pill is expected to be accessible in major retailers and online in early 2024. During a conference call with journalists Thursday, Perrigo CEO Frederique Welgryn stated that the pricing of Opill will be announced in a couple of months before the pill is available in shops.


Welgryn stated that the firm is committed to keeping Opill inexpensive. Perrigo is establishing a patient assistance program to ensure that the cost of the pill is not a barrier for women who are trying to make ends meet.

However, some women and girls may still experience difficulties in obtaining Opill. The ACA does not compel private health insurance to reimburse the cost of the medication when taken without a prescription. Most health insurance companies are mandated to provide free birth control when recommended by a doctor.

According to the federal Centers for Medicare & Medicaid Services, state Medicaid programs are likewise not obligated to cover medications supplied without a prescription.

Perrigo is now working on insurance coverage.

According to Welgryn, Perrigo is attempting to recruit commercial insurance and state Medicaid programs to provide free over-the-counter Opill to women and girls. However, she believes that the Affordable Care Act should be amended to ensure that birth control without a prescription is covered by health insurance.

Welgryn stated that it is unknown if Opill would be covered by insurance when it becomes available in stores early next year. “We’ll need to put in some effort to make that happen.” “It’ll take time,” she said.

Democrats in Congress, as well as President Joe Biden, are advocating for more access to contraceptives.
Sen. Patty Murray, D-WA, reintroduced Affordability is Access legislation in the Senate in May, requiring health insurance to provide free oral contraception without a prescription.

In June, Biden directed the US Department of Health and Human Services to guarantee that all FDA-approved contraceptives are offered without out-of-pocket payments.

According to a CMS representative, the government is urging health insurance companies to cover over-the-counter contraceptives for free. According to the spokeswoman, the agency is working on methods to guarantee that contraceptives authorized by the FDA for use without a prescription are available without cost sharing.

Opill has a 93% success rate in preventing pregnancy. In the United States, it is the most effective method of over-the-counter contraception. To guarantee its efficiency, the tablet should be taken at the same time every day.

According to Welgryn, 15 million sexually active women in the United States who do not want to become pregnant use a type of contraception that is less effective than Opill or no contraception at all.

According to the FDA, about half of the six million pregnancies in the United States each year are unplanned. According to the organization, unintended pregnancy is connected to premature birth, which can result in poor health outcomes for babies.