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An answer from Slate medical columnist Amanda Schaffer to my question about why the Pill is a prescription drug. Amanda supports, with caveats, Kerry's argument that oral contraceptives should be sold over the counter:
The downside risks of the pill (strokes, breast cancer) are pretty small, especially with newer formulations. And the upside of reducing ovarian cancer risk (as well as preventing unwanted pregnancy, of course), has led some researchers to argue for over-the-counter access; in fact, a meta-analysis in the Lancet from last year had an accompanying editorial making this case. The counterargument is that women who smoke or get migraines should not be on the pill, and a doctor's involvement might prevent that from happening. Plus, since women stay on oral contraceptives for long periods of time, it may be wise to have more medical oversight.
Amanda and I disagree with you, Kerry, that annual visits to the gynecologist are a waste of time. Breast exams, pelvic exams—that's trouble-catching time.
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I, too, applaud the move to make Plan B available over the counter for 17-year-olds, but, Kerry, I have to raise one problem that could accompany making hormonal birth control OTC: insurance. Many insurance plans don't cover OTC medication, unless it's a special program intended to keep costs down, like providing an incentive for people to use a specific OTC heartburn medication instead of an expensive prescription drug that's not more effective. Insurance companies like the checks and balances of going through a doctor and a pharmacist before shelling out. Yaz, which you mention, costs about $60 per month retail, I believe, depending on the store, the state, etc. Planned Parenthood and other resources might step in to help, but those of us who already have high copays on birth control would feel the hit if we had to start paying full price. Considering the battles waged over getting insurance companies to pay for birth control, I can't imagine that many plans would be willing to alter their OTC policies to cover the an over-the-counter pill.
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Back during the ridiculous brouhaha over access to the morning-after pill, regulators compromised by making the pill available without a prescription only to women of 18 years of age or older. A federal judge, noting that this restriction is arbitrary and without medical justification, has ordered the FDA to review the policy and make Plan B available to 17-year-olds in 30 days. I imagine that the policy will change pretty quickly; you know things are looking up when the Washington Post has to go to Concerned Women for America to find some quotable pushback.
All of which allows me to climb astride an old hobby horse: Regular old birth control ought to be available without a prescription. Hormonal birth control meets all of the FDA requirements for over-the-counter access; Plan B, after all, is just a mega-dose of the pill. We've all heard stories of women being denied birth control by squeamish doctors and pharmacists; there is no reason such women shouldn't be able to grab stacks of Yaz off the shelf at Walgreens. The aggregate burden of all those pointless doctor's appointments and hourlong pharmacy waits is surely massive.
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