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Emily, thanks for the link to that meta-analysis in cautious support of over-the-counter birth control. For what it's worth, I certainly didn't mean to imply that annual cancer screenings are a waste of time. I am arguing that doctor's visits made solely for the purpose of obtaining permission to access a relatively safe form of contraception are pointlessly and harmfully burdensome. I've had to make quite a few such visits, in part because I move frequently and am incapable of getting an overworked doctor on the phone with an understaffed pharmacy. It's possible that I am overgeneralizing from my own deeply annoying experiences.
I've lived in countries where the pill is kept behind the counter and would be more than happy with such a compromise. But the FDA, unlike its counterpart agencies in England and Canada, only very rarely considers this third option due to complex regulatory barriers. (When the FDA rejected OTC status for Merck's Mevacor, for instance, several panelists said they'd be comfortable with the drug as it is sold in British pharmacies; in other words, behind the counter. They weren't given such an option, so the panel overwhelmingly voted down the application.) It's not clear that the FDA even has the authority to create a third class of drugs. But thanks in small part to Plan B, it looks like our binary classification system might be changing.
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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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