Over-the-Counter Oral Contraception as an Opportunity to Reduce Contraceptive Access Inequity

Kristyn Brandi, Krishna K Upadhya, Stephanie B Teal

JAMA

On May 10, 2023, the Food and Drug Administration (FDA) convened a joint meeting of the Nonprescription Drugs Advisory Committee and the Obstetrics, Reproductive and Urologic Drugs Advisory Committee to evaluate the application for Opill, a progestin-only contraceptive pill, to move to over-the-counter (OTC) status. The members of the advisory committee voted unanimously to support the application, citing data that most patients can use progestin-only pills safely and effectively. Organizations such as the American Medical Association, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists have long supported efforts to have progestin-only pills available OTC, as they are in more than 100 other countries. Although the final decision will not be released until the summer or fall, the advisory committee vote is a promising step to improved contraceptive access for US residents. Given the patchy state of US health insurance coverage, the recent loss of pandemic-related Medicaid expansion for millions, and that 17% to 53% of US residents live in contraceptive deserts, reducing logistic barriers to contraceptive access is imperative.