First on CNN: First over-the-counter birth control pill in US ships to retailers, costing about $20 for one-month pack

By Jacqueline Howard, CNN

(CNN) — Opill, the first oral contraceptive approved for over-the-counter use in the United States, will be available in stores and online this month, with a manufacturer’s suggested retail price of $19.99 for a one-month supply and $49.99 for a three-month supply, according to Perrigo, the company behind the product.

Perrigo announced Monday that Opill has shipped to major retailers and pharmacies and will be available to pre-order from select retailers beginning this week. Once the product hits shelves, anyone can buy it without a prescription. It will also be available at Opill.com.

“From an online perspective, it should be available for order pretty much immediately,” said Triona Schmelter, executive vice president and president of consumer self-care Americas at Perrigo.

As for the availability, “I expect it’s going to take a few weeks for it to get through the distribution pipeline, of us shipping to retailers’ distribution facilities and then them shipping to their stores,” she said. But once the product is on shelves, “consumers will find it in the family planning section in most retailers and should be able to pick it up at their convenience.”

Opill will be available in stores and online as one-month and three-month packs, according to Perrigo. And at Opill.com, a six-month supply will be available at a price of $89.99.

When taken as directed at the same time every day, Opill has been found to be 98% effective at preventing pregnancy, according to Perrigo. Most birth control pills are up to 99% effective at preventing pregnancy if taken as instructed every day.

“We’re excited about this. It looks very good,” Patrick Lockwood-Taylor, president and chief executive officer of Perrigo, said of Opill’s rollout in a company earnings call last week. “The product is here, waiting to be distributed.”

Walgreens and CVS have said they will offer the product.

“Opill will be available at CVS.com and through the CVS Pharmacy app in late March,” spokesperson Matt Blanchette wrote in an email Friday. “In early April more than 7,500 CVS Pharmacy stores will offer Opill and for added privacy and convenience, customers will be able to choose same-day delivery or buy online and pick-up in store.”

Some online retailers, such as the women’s health hub Stix, are poised to offer the product, as well. Stix founders Jamie Norwood and Cynthia Plotch said they are “excited” about the significant milestone that Opill marks for the accessibility of contraception but are “acutely aware” of the impact that cost may have on access.

A survey conducted by the nonprofit KFF in 2022 found that among women who said they were likely to use over-the-counter birth control pills, 39% said they were willing and able to pay up to $10 per month for them, 34% would be willing and able to pay up to $20 per month – the recommended cost of a one-month pack of Opill – and only about 16% said they would pay more than $20. Under the Affordable Care Act, most insurance plans are required to offer coverage of birth control with no out-of-pocket cost, so it is free.

“With these insights, Stix is committed to breaking down financial barriers, ensuring that essential health products and services are within reach for everyone,” Norwood and Plotch said.

Plotch said Opill “is going to be really amazing for people who don’t otherwise have access to the prescription form of oral contraception that is covered by health insurance.”

Last year, the US Food and Drug Administration approved Opill for over-the-counter availability, meaning it can be obtained without a prescription. Since then, questions have swirled around how much it would cost.

A group of advocates called Free the Pill is among those urging a lower price. In January, Free the Pill sent a letter to Perrigo, calling on the company and retailers to price Opill at only $15 for a three-month supply.

“We also urge Perrigo to implement a robust and accessible consumer assistance program for those who cannot afford to pay that price,” the letter said. “Perrigo’s and retailers’ decision to price Opill affordably can help to combat contraceptive inequities – rooted in systemic racism and other forms of oppression – that already persist across the United States.”

Perrigo’s Schmelter said that advocacy groups like Free the Pill have been “essential in building the research, in educating the public, educating us, and being an advocate for bringing a birth control pill over the counter.”

She added that Perrigo will have a cost assistance program available for qualified low-income and uninsured people, which will be available in the coming weeks.

“We really wanted to think about all consumers as we were crafting our pricing strategy just to make sure that it was accessible to our consumers, and ensure both affordability and availability on shelf,” Schmelter said.

For people with insurance, Opill may be eligible to be paid for or reimbursed through flexible spending or health savings accounts, according to Perrigo.

Issues of cost and insurance coverage could still put Opill out of reach for some people, but overall, an over-the-counter birth control pill is a “great step forward,” said Dr. Colleen Denny, director of family planning at NYU Langone Hospital – Brooklyn, in an email.

“Having an over-the-counter, highly effective birth control option on the shelves is potentially a great step forward in improving access to high quality birth control. We know that getting a prescription medication, which is required for all other birth control pills in the U.S., can potentially be a big barrier for patients,” she wrote. “A pill you could buy off the shelves could potentially help with that.”

Opill works as a “mini-pill,” using only the hormone progestin to prevent pregnancy. Combination hormonal birth control pills, which contain both progestin and estrogen, increase the risk of blood clots more than progestin-only birth control pills, said Dr. Asima Ahmad, chief medical officer and co-founder of Carrot Fertility, a global fertility care platform.

“Progestin-only pills do not increase the risk of having a blood clot like combined OCPs can, which can make it a great option for some people who cannot take combination OCPs,” Ahmad wrote in an email, referring to oral contraceptive pills.

“The pill does need to be taken at the same time every day to be effective,” she said, “but if it is not taken consistently and around the same time every day, the effectiveness drops.”

Because Opill is a progestin-only oral contraceptive, it is “incredibly safe” for the vast majority of people who may be interested in taking it, said Dr. Ashley Brant, director of complex family planning at Cleveland Clinic.

Combined birth control pills may carry risks for people with uncontrolled hypertension or blood clot risks for smokers older than 35. Contraindications for progestin-only pills include conditions such as breast cancer or liver disease, or the use of certain medications.

“Birth control pills are either progestin-only, or they’re estrogen plus progestin. For most people, either birth control pill will be safe, but the progestin-only pill in particular has very few contraindications to it. There are very few medical reasons why a progestin-only pill would be unsafe for someone,” Brant said, adding that overall, Opill is a “great step” toward making birth control more accessible.

“Now, there will still be lots of people who prefer to come to their trusted health care professional, talk about other options, get a prescription, use their insurance to cover a prescription – and that way of getting birth control isn’t going to go away,” she said. “This is just one extra way to get birth control that we didn’t have before.”

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