June 23, 2015 — A proposal (S 1532) that would require insurers to cover over-the-counter access to oral contraceptives would better ensure access and affordability than an alternative conservative proposal (S 1438), Daniel Grossman, a clinical professor at University of California-San Francisco and vice president of research at Ibis Reproductive Health, writes in a Los Angeles Times opinion piece.
Grossman explains drugmakers might be wary of applying for FDA approval to make oral contraception available OTC because they "fear ... political interference -- and the costs and uncertainty it introduces -- in the FDA approval process." For example, he writes that when lawmakers changed the FDA's approval process to make Plan B emergency contraception available OTC, progress slowed down, resulting in "an unreasonable age restriction ... that was lifted only after a 10-year legal battle."
According to Grossman, the conservative proposal "would also interfere with the FDA process" by "giv[ing] priority FDA review and waiv[ing] the filing fee only for an OTC pill to be sold to those older than 17." Grossman notes there is no medical need for such an age restriction. Further, the bill's requirement that people "show proof of age" before accessing OTC oral contraception could deter "people with the most to gain from the non-prescription pill," such as undocumented immigrants, and might "creat[e] extra work for pharmacists," potentially "increas[ing] the cost of the pill and limit[ing] access to it."
In addition, Grossman writes that the conservative proposal would allow people to "use pretax dollars in flexible spending accounts or health savings accounts to buy over-the[-]counter medications without a prescription," which he notes "is unlikely to help women who struggle to pay for birth control." By contrast, the bill proposed by Sen. Patty Murray (D-Wash.) is would improve access to contraception because "it would extend the contraceptive coverage guarantee under the Affordable Care Act [PL 111-148] to include the FDA-approved [OTC] pill," he writes.
Grossman writes, "[OTC] access to the pill could be a game-changer for public health, eliminating an unnecessary barrier to a highly effective form of birth control" and "[t]he support of politicians from both sides of the aisle to help make this a reality is welcome." However, he adds that lawmakers "must stay out of the drug regulatory process and let the FDA do its job" (Grossman, Los Angeles Times, 6/19).