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Why Does the Pill Require a Prescription in the US?

| October 10, 2014 Comment

Why Does the Pill Require a Prescription in the US? The US is in the global minority in requiring prescriptions for birth control pills.

A few political ad campaigns this season raised a really interesting question – why does birth control require a prescription in the US? There are politics to the debate, to be sure, but we’re more curious about the underlying question.

As it turns out, worldwide the US is in a minority in requiring a prescription to get the pill. Only about a third of the world’s countries limit access, including Canada, Australia, and Japan. Countries like China, Russia, and Mexico offer the drug over the counter.

So, what’s the rationale behind requiring a prescription? Proponents say the pill can increase women’s risk for blood clots, heart attacks, and stroke, especially among smokers and older women. The thinking here is, under a physician’s direction, these risks are mitigated. But many over-the-counter drugs like aspirin, which can cause stomach bleeding, also have potentially serious risks and don’t require a prescription. On top of that, critics of the current prescription only system argue that women can do the research and decide for themselves whether they’re good candidates for birth control.

Critics, like the American College of Obstetricians and Gynecologists, say unplanned pregnancies would likely go down in the US if prescriptions were no longer required to take the contraceptive pills.

In 2012, about 60% of women not currently using contraceptives said they would begin using them if they became available over the counter. And consider this — sales of nicotine-replacement therapies went up by 150% to 200% the first year they were offered without prescription. The US Food and Drug Administration (FDA) would have to approve any changes to oral contraception’s prescription-required status. There aren’t any plans to do that yet, but as we mentioned earlier, there are a couple of Republican candidates for senate that are calling for that to happen.

Cynics will say that that’s a move to skirt ObamaCare requirement that health insurance companies completely cover the cost for birth control. Or, as two health writers put it,” replace one barrier (ease of access) with another (cost).” And that’s why proponents of change, in general say, that in order to really improve access to oral contraceptives, both have to happen – over-the-counter status as well as preserving the requirement of insurance companies to cover the cost.

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