First over-the-counter birth control pill to hit U.S. stores in 2024

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The push to make an oral contraceptive available without a prescription predates Biden’s presidency. But the issue took on fresh urgency when the Supreme Court overturned Roe v. Wade in 2022, particularly as conservatives openly questioned the legal precedent establishing the right to privacy for birth control access. Within weeks of the ruling, a contraceptive maker, which had spent more than six years studying consumers’ ability to use the product correctly without a doctor’s supervision, applied to the FDA for over-the-counter approval.
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Article Contents

The move

Despite concerns from FDA scientists about consumers’ comprehension of the drug’s proper use and risks, in July 2023 the agency endorsed making the pill available over the counter.

The impact

CVS and Walgreens, two of the country’s biggest retail pharmacies, have pledged to carry the contraceptive, called Opill, once it’s available in early 2024. Reproductive rights advocates say an OTC oral contraceptive will help make birth control access more equitable by reaching people who can’t afford or easily visit a health care provider for a prescription.

The upshot

Opill’s success will come down to its retail price and whether public and private insurers opt to cover it. The Affordable Care Act requires most private health plans to cover contraception at no cost to consumers, but insurers generally don’t cover OTC medications unless they’re prescribed. Advocates for greater contraception access say those policies create a barrier for the uninsured, teenagers and people of color. But mandating no cost-sharing could create challenges at the point of sale for pharmacists and insurance plans. The Biden administration is considering requiring no-cost coverage of OTC items like Opill without a prescription by most commercial plans.

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