March 4, 2024 – Today, in a historic step forward for reproductive health, Perrigo announced that the first-ever over-the-counter (OTC) birth control pill in the United States, a progestin-only birth control pill (POP) called Opill, is now available for pre-order from select online retailers and is expected to be on store shelves at major retailers nationwide in the coming weeks. After a comprehensive review of the data and a unanimous advisory committee vote to recommend Opill for OTC status, the FDA approved Opill for people of all ages as the first OTC birth control pill in US history on July 13, 2023. Opill will soon be the most effective form of birth control available without a prescription in the United States and will impact countless people’s lives by allowing them the autonomy to take charge of their reproductive health without the unnecessary barrier of a prescription requirement. However, at a price of $19.99 per pack, there is more work to do to reduce cost barriers and ensure that Opill is equitably accessible.
Opill’s FDA approval was a movement-driven win that comes after 20 years of advocacy and research led by members of the Free the Pill coalition—comprised of over 200 reproductive health, rights, and justice organizations, youth activists, health care providers, researchers, medical and health professional associations, and others. The Free the Pill coalition, which is operated by Ibis Reproductive Health, recognized the potential of over-the-counter birth control pills to expand equitable access to contraception and has continued working since 2004 to make this vision a reality. Ibis’s partnership with Perrigo (formerly HRA Pharma) in 2016 paved the way for this first-of-its-kind Rx-to-OTC switch application, and coalition members’ written and oral testimony were key factors that helped inform the FDA advisory committee’s unanimous recommendation in May 2023 to make Opill available OTC and FDA approval without an unnecessary age restriction.
The coalition’s ongoing commitment to using a reproductive justice framework and its adoption of a youth-adult partnership approach were critical to this win. And this focus on equitable access for all requires us to ensure that those who face the most barriers to access can benefit from OTC birth control pills. At Perrigo’s suggested retail price of $19.99 per pack, many people—especially those who currently face the most barriers to access due to systemic inequities and other forms of oppression—may not be able to afford Opill nor benefit from OTC access. Research and polling found that half of adult and teen respondents interested in using OTC birth control pills would be able to pay only $10 or less per month for the product. A monthly cost of $19.99 per pack will leave many people without access and others to choose between getting birth control OTC and maintaining their monthly budget. No one should be denied access to basic health care due to cost barriers.
As we work toward our vision of equitable access to OTC birth control pills, we will continue to advocate for affordable options. We are glad to see that Perrigo has introduced a cost assistance program for Opill to help ensure access for those for whom this price is out of reach. We look forward to learning more about the program, and reiterate our call on Perrigo to ensure it meets the equity priorities the Free the Pill steering committee recommended, including to ensure it is inclusive of people of all ages and accessible to those who face the greatest barriers to contraceptive care. We also urge Perrigo to make every effort to reduce the price, and to find ways to work with community-based organizations, clinics, and other interested partners to make free or no-cost Opill available to those who cannot pay this price. We will also double down on our advocacy at the state and federal levels, as well as with private insurers, to expand public and private insurance coverage of OTC birth control without a prescription requirement or co-pay. Meanwhile, we call on retailers to stock Opill visibly and without barriers nationwide, and to price Opill as affordably as possible to ensure access for everyone. This OTC switch will not be successful until Opill is accessible and affordable to everyone who wants and needs it, and no one is left behind.
Free the Pill’s Steering Committee released the following statement—
"Today we mark a new era for contraceptive access and celebrate as the US will soon join over 100 countries worldwide where birth control is available without a prescription. This accomplishment is a testament to the Free the Pill coalition’s decades of collective organizing, resilience, and grit. Opill being over the counter will benefit countless people who rely on contraception to help plan their lives and futures. Still, the current price will create barriers for some, as due to systemic inequities, cost barriers fall harder on young people and those working to make ends meet. It is essential that we continue our efforts to ensure that there are other lower and no-cost options for accessing Opill, and that OTC contraception is fully covered by insurance and available without barriers for all who need it."
Victoria Nichols (she/her), project director of Free the Pill, a project of Ibis Reproductive Health focused on bringing birth control pills over the counter in the United States, released the following statement –
“The first-ever over-the-counter birth control pill, Opill, will be available online and on store shelves in the coming weeks in the United States. This is a landmark moment for public health nationwide that reflects two decades of research and advocacy led by the Free the Pill coalition! As we celebrate this pivotal advance, we recognize that there is still work to be done to ensure that contraception is accessible to every person who wants and needs it. At $19.99 for a one-month supply, Opill’s suggested retail price will create barriers to access, especially for young people and those working to make ends meet. Due to systemic inequities, cost can mean the difference between people getting effective contraception or going without. We urge Opill’s manufacturer to implement a robust consumer assistance program to ensure access to the most effective over the counter contraceptive option for people who face cost barriers. Further, we urge our policymakers at the state and federal level to act now to ensure that over the counter birth control is fully covered by insurance without a prescription or cost sharing.”
Kelly Blanchard (she/her), president of Ibis Reproductive Health, a global nonprofit research organization which operates the Free the Pill coalition, released the following statement –
“Today we celebrate an important and historic milestone—the first-ever over-the-counter birth control pill is shipping to retailers this week. This is a long overdue breakthrough made possible in part by the amazing work of the Free the Pill coalition partners and backed by decades of science and research. This transformation in access has the potential to be a game changer, especially for people who face barriers to contraception due to the structural racism in our health care system. Yet, at $19.99/pack MSRP, Opill will remain out of reach for many people working to make ends meet. Our commitment to bringing a birth control pill over the counter has always centered on equity, and we are committed to ensuring that the company, retailers, and the Biden administration are doing everything in their power to guarantee access for everyone. Insurance coverage, a robust consumer assistance program, and getting OTC birth control into clinics and communities where people can access it at no charge are critical. We will continue our work to advocate for and test ways to make sure everyone has access to this amazing advancement in contraceptive availability.”
Lupe M. Rodríguez, executive director of the National Latina Institute for Reproductive Justice and Free the Pill coalition steering committee member, released the following statement –
"We are thrilled to see Opill become available over-the-counter and can’t wait for it to be stocked in pharmacies across the country. This is a long-overdue victory that gets Latinas/xs and other communities of color closer to being able to make meaningful decisions about whether and when to become parents. Over-the-counter access to birth control will greatly reduce the barriers like transportation, cost, language, and documentation that prevent Latinas/xs from getting the care they need. Now, we must ensure that all of our communities can benefit from this historic moment. We call on retailers nationwide to price Opill affordably and stock it on store shelves without barriers, and insurers to fully cover this without a prescription or cost-sharing.
At the Latina Institute, we are committed to building power in Latino/x communities across the country so that everyone has access to the healthcare they need. We are proud to be a part of the Free the Pill coalition that advocated for Opill to be priced affordably, and we look forward to helping our communities learn more about this safe and effective birth control pill.”
Maia Lopez, a 17-year-old organizer with Advocates for Youth and Free the Pill coalition steering committee member, released the following statement –
“After years of organizing for over-the-counter birth control, I’m thrilled that young people like me will finally be able to access Opill without a prescription. As a high school student in Texas who struggled to get on The Pill under the current system, and faced social stigma while trying, I know firsthand how important it is to ensure young people can walk into a store and easily access the contraception they need. While today is a huge step forward, the price is still steep for many teenagers I know. I don’t want Opill to be inaccessible to people who already face barriers from strict contraceptive policies. Our work is not done until every young person can afford and access Opill.”
Dr. Daniel Grossman (he/him), director of Advancing New Standards in Reproductive Health (ANSIRH) and Free the Pill coalition steering committee member, released the following statement –
"This is a truly historic milestone for reproductive health in the United States. A robust body of evidence—including studies I have led—indicates that birth control pills can be taken safely and effectively without a prescription. Opill will help address the barriers to birth control that far too many people face far too often. Still, this price point could pose a financial barrier to some patients who need care. I look forward to learning more about Perrigo's consumer assistance program and supporting efforts to expand insurance coverage for over-the-counter contraception."
Rochelle Rodney (she/her), co-executive director of the New York Birth Control Access Project and Free the Pill coalition steering committee member, released the following statement –
“Birth control allows people to make informed decisions about their lives and futures. That’s exactly why we’ve been working for years to expand access to contraception for New Yorkers. Now, with Opill being available over the counter, people across the country will be able to access one more tool that helps them make informed decisions about their reproductive health.”