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Heard this on NPR yesterday.  My first thought:  "Obamacare requires Health Insurance companies to pay 100%, no  co-pay, of birth control for women.  How will this affect profits for the BC manufacturers?"

Cynical?  Perhaps.  However, anyone followig Birth Control know that some side effects can be lethal.  

If you participate in the poll below, please leave a comment below.  If you vote "Yes, good idea" it would be interesting to know whether you are male or female and why you think it is a good idea.  If you vote "No, bad idea, it would be interesting to know why you think so.  Thank you.

Here's an OTC Birth Control justification:

The Affordable Care Act, beginning in August and Jan, 2013 (depending on a few details) requires Health Care Insurers to provide birth control WITH NO CO-PAYS.

So what could OTC Birth Control pills cost?  About $2.00 a day according to the price list below

From WikiAnswers:

These are the prices for birth control at the #1 Birth Control pharmacy.

Prices:

Yasmin 21
63 tabs (21x3) - USD $65
$21.67 / month CAD $76 | GBP £33 | EUR €49

Yasmin 28
84 tabs (28x3) - USD $76 CAD $89 | GBP £39 | EUR €57

Yaz
84 tabs - USD $73 CAD $85 | GBP £37 | EUR €55
Triquilar 28
84 tabs - USD $65 CAD $76 | GBP £33 | EUR €49

Triquilar 21
126 tabs - USD $89 CAD $104 | GBP £46 | EUR €67
l
Tadalafil
96 tabs - USD $219 CAD $257 | GBP £113 | EUR €165

Plan B
1 pack (2 tabs) - USD $42
Free Shipping CAD $49 | GBP £22 | EUR €32

Portia 28
168 Tablets (6 Packs of 28) - USD $79 CAD $93 | GBP £41 | EUR €60

Ortho-Evra
18 patches - USD $215
$35.83 / month CAD $252 | GBP £110 | EUR €162

Ortho Tri-cyclen 21
63 tabs - USD $69 CAD $81 | GBP £35 | EUR €52

Ortho Tri-Cyclen Lo 28
28 tabs - USD $38 CAD $44 | GBP £19 | EUR €29

Ovral 21
63 tabs - USD $89 CAD $104 | GBP £46 | EUR €67

Ortho Tri-cyclen 28
84 tabs - USD $69 CAD $81 | GBP £35 | EUR €52

Ortho 777 21
63 tabs (21x3) - USD $67 CAD $78 | GBP £34 | EUR €50

Ortho-Cept 21
63 tabs - USD $52
Free Sample
CAD $61 | GBP £27 | EUR €39

Nuvaring
1 ring - USD $40
3 ring - USD $90 CAD $105 | GBP £46 | EUR €68

Alesse (21)
63 tabs - USD $79 CAD $92 | GBP £41 | EUR €59

So, now that birth control is 100% affordable, OB-GYNs are recommending that BC be moved from a prescription medicine, to over-the-counter?  

Am I the only cynic in the room?  The timing of this change of heart by the OB-GYNs seems odd to me.

More about birth control and the The Affordable Care Act from Planned Parenthood

Here's what I don't understand. I don't think anyone, if asked, would say they LIKE abortion; however, many of these same people are adamant, vocal, sometimes even murderous about abortion, while I think a majority of people feel that they have no right to dictate this emotional decision for others.

That said, access to free birth control has proven to reduce abortions.

Free birth control tied to drop in abortions

Honestly, it makes my brain hurt trying to square the conflicting No Abortion, No Birth Control crowds thinking.  The Pope is very anti-birthcontrol.  

Pope supports birth-control fight - Bishops oppose federal mandate

Excuse me, but these MEN don't have wombs.  How is it acceptable that they think they have ANY right to dictate the terms of women's bodies?  lives?

Women in America FINALLY have access to free birth control, if they can afford the doctor's visit or take advantage of clinics/services like Planned Parenthood, and the OB-GYNs are pushing to move the market to Over-The-Counter, an unaffordable alternative for too many women.

Head spinning proposal in my opinion.

Birth Control requires medical monitoring, as each woman has a different reaction to different BC products.

And YAZ is suspected by many to even cause death:

Yaz and Yasmin Deaths May Exceed 190 in United States Alone: Report

More than 190 American women may have died as a result of the potential side effects of Yaz and Yasmin birth control pills, according to an organization devoted to curbing corporate misbehavior by Bayer.
We lost a friend that was taking Yaz, btw.  Coincidence?

There are many lawsuits, as a matter of fact.

Yaz Lawsuit Information
Yours?

If birth control becomes an OTC product, how will young women be monitored?  Who will guide them to make a good choice for them, who will have liability if a product is proven harmful?  Are the OB-GYNs prescribing YAZ culpable if they lose a patient?

There are just too many questions, too many risks, and too much proof that Birth Control is a powerful drug and its use requires interaction between a woman and her doctor.

Poll

OTC Birth Control

55%59 votes
44%48 votes

| 107 votes | Vote | Results

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Comment Preferences

  •  I think it's a bad idea (7+ / 0-)

    There are real risks with taking hormonal birth control and you should be evaluated by your dr or midwife to see if it's appropriate for your situation.

  •  Actually, no. (21+ / 0-)

    It is much more likely you will have a severe side effect from Tylenol, for instance.  It is very harmful to overdose on Tylenol, and too much Advil causes severe stomach issues.

    The new medical guidelines also decouple a visit to your doctor to your BC prescription, because it's unnecessary and a barrier to receiving contraception.

    This whole idea that BC is "dangerous and powerful" is pushed by the anti-choice lobby, and I'm unhappy that you seem to have bought the BS.

    The OB/GYNs are right.  We have much more to lose by a 50% unintended pregnancy rate than the outlier of Yaz.

    •  Do you see the out-of-pocket expense (11+ / 0-)

      for OTC BC as a barrier for low-income women?

      That is a big concern for me.  Women finally receive BC at no charge via Obamacare rulings.  

      It's difficult to be happy knowing so many suffer. We must unite.

      by War on Error on Wed Nov 21, 2012 at 07:13:26 AM PST

      [ Parent ]

    •  I brought this up below but I also want to ask (1+ / 0-)
      Recommended by:
      gramofsam1
      The new medical guidelines also decouple a visit to your doctor to your BC prescription, because it's unnecessary and a barrier to receiving contraception.
      Are you concerned that women will skip their yearly PAP/exam if it no longer is a requirement to get their prescription renewed? I know that is the only thing that gets many women into the stirrups.

      What would be the potential impact overall to women's health if they no longer had this as a driving force? It's an interesting possible side effect.

      •  Since only 28% of women (3+ / 0-)
        Recommended by:
        entrelac, wu ming, splashy

        ... use BC pills, there had better be more methods for getting them "into the stirrups."

        •  But that's nearly a third of women (0+ / 0-)

          that are at risk of skipping potentially life saving exams.

          That number makes this possible side effect all the more relevant to the conversation.

          •  Actually, it points up a really big problem (3+ / 0-)
            Recommended by:
            wu ming, entrelac, splashy

            The real issue is that we need women to see their doctors regularly, regardless of what kind of birth control they choose. What is preventing that? I'd wager it's the cost, even if you have insurance, which nearly half of all women in the US don't have.

            I think the "protection" attitude related to the pill needs to be examined carefully. Yes, there are risks, but there are equal or greater risks to all sorts of other things already available OTC. Risk mitigation is handled, generally, via labeling for other medications. Aspirin causes internal bleeding; acetaminophen causes liver damage; ibuprofen causes kidney damage, internal bleeding, and liver damage; proton pump inhibitors can cause vitamin B-12 deficiency and nerve damage. The risk of blood clots and strokes is serious, but so is the risk of a brain bleed with aspirin.

            The real issue, to me, is still the cost of getting health care. If that were dealt with properly, it almost wouldn't matter what is sold OTC, because there wouldn't be a need to push people to the doctor's office.

            In the mean time, it's not entirely uncommon for women without health care in southern CA to take a day trip to Mexico to buy birth control OTC.

            •  Talking to women (1+ / 0-)
              Recommended by:
              radical simplicity

              of all walks of life the most common reason I've been given is the embarrassment/comfort factor. Getting a pelvic exam is invasive and emotionally uncomfortable for most women.

              Cost is a close second, though I know many uninsured women who use Planned Parenthood.

              My concern is the fact that hormones are powerful drugs and they affect women differently. There are also a number of strengths and combinations of the 2 estrogens and 7 progesterones that are commonly used in the formulations.

              Would you know which one is right for you?

              Would you stick it out for the 3 months it generally takes your body to adjust?

              Do most women know the difference between extended-release pills, combination pills ( triphasic, monophasic and biphasic) and progestin-only pills?

              Plus, if one formulation goes OTC (like in the Claritin examples) will insurance then stop covering the others?

              Putting BCP's OTC is not even close to being in the same category as allergy, heartburn, and minor pain medications.

              •  A pelvic exam is not only uncomfortable (1+ / 0-)
                Recommended by:
                entrelac

                And invasive, it can be painful, especially if there is a problem like an infection or other problems.

                The possibility of having to get a biopsy, which can be very painful, tends to make a person not want to go.

                Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

                by splashy on Wed Nov 21, 2012 at 02:02:40 PM PST

                [ Parent ]

      •  Not getting pregnant (0+ / 0-)

        Is one of the most potentially life saving things there is.

        Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

        by splashy on Wed Nov 21, 2012 at 01:57:18 PM PST

        [ Parent ]

  •  hmmm (9+ / 0-)

    "Who will have liability if a product is proven harmful?"

    As always, the answer is...the manufacturer.  We don't hold doctors liable because a medication they prescribe turns out to have been inadequately tested or fraudulently labeled by the manufacturer.  Allowing pharmacists to dispense BC OTC would have no effect on this at all.  

    Pharmacies already offer Plan B over-the-counter.  Plan B is just a short-term, high dose of birth control.  The women's health community has been kicking around the idea of OTC birth control for years now.  You may have just heard about it today, but this is old news...there's no suspicious timing.  

    And as someone who has been on birth control for...a number of years...there's no "monitoring" by my doctor.  I go in once a year for my annual and my gynecologist performs the usual physical exam (which doesn't have anything to do with side effects of the pill, except for the bp check).  It's not like she's calling me weekly and getting my to palpate my legs for clots.  

    Final word - you listed the prices for a number of common bc pills.  You also listed the price for an erectile dysfunction drug.  All of this leads me to believe that you need to do your homework more thoroughly before writing this dairy.  

  •  I think this is a bad idea (6+ / 0-)

    This could be fatal for uninformed users who don't  know how the pill could affect existing health conditions.

    And this just seems like an end run around providing this a part of health care. Hormonal BC is used for a variety of reasons that should be monitored by a doctor. It should remain prescribed and it should remain ( now , thankfully) covered by insurance.

    We view "The Handmaid's Tale" as cautionary. The GOP views it as an instruction book.

    by Vita Brevis on Wed Nov 21, 2012 at 07:13:29 AM PST

    •  I totally agree. Busy women don't necessarily (5+ / 0-)

      have the time to figure out stuff they have no background in. And my mom's an OB-Gyn has many stories of women misled by advertising and poor research. The drug companies aren't saturating the airwaves because they're advertising doesn't work- it's clearly been very effective at manipulating the uninformed public. I've seen ads for drugs that I'm on that are just grotesquely misleading. The industry has no conscience. I think that's obvious at this point.

      •  Yep- the advertising is driving (2+ / 0-)
        Recommended by:
        entrelac, Catte Nappe

        medical decisions to an unhealthy degree. And I'm always struck by how often a drug ad is immediately followed by an ad for some ambulance-chasing law firm trying to enlist people in a lawsuit against a drug company. The whole picture is pretty twisted.

    •  Tylenol could be fatal for uninformed users who (2+ / 0-)
      Recommended by:
      radical simplicity, wu ming

      don't  know how the pill could affect existing health conditions.  Let me repeat this, one extra Tylenol above the maximum dosage on the package per day WILL CAUSE SEVERE LIVER DAMAGE!

      You have watched Faux News, now lose 2d10 SAN.

      by Throw The Bums Out on Wed Nov 21, 2012 at 09:18:31 AM PST

      [ Parent ]

      •  Taking one Tylenol, once, with alcohol (4+ / 0-)

        Can kill your liver.

        There is no safe combination of the two. Even with the current labeling, how many people do you think come home from a day of construction work, toss back a couple Tylenol, then sit down with a beer before dinner?

        It took me half an hour to get one young adult I know to promise NEVER to mix the two, after he mentioned that's what he was going to do once he got home after some set construction at the local theater. I also had to make him promise never to take more than the labeled dosage. I had to explain that if the label dose didn't stop his pain, it was because he was using the wrong pain killer for the kind of pain he had, and he should try ibuprofen next time, to see if that worked better.

        People have no idea how dangerous that one drug is. The only reason I know about it is because my BIL lost his liver due to taking Tylenol w/beer.

    •  This is one reason I don't think it's a great idea (2+ / 0-)
      Recommended by:
      Vita Brevis, entrelac

      People tend to "self-prescribe" and "self-medicate". I can see some deciding to use OTC hormones, that they otherwise might not opt for or need as birth control, to address other issues such as painful menses, or acne, or whatever other conditions internet fora are likely to toss out as benefiting from a little hormonal help.

      "...you can’t find any oxygen from outside the aircraft to get in the aircraft, because the windows don’t open. I don’t know why they don’t do that. It’s a real problem." Mitt Romney

      by Catte Nappe on Wed Nov 21, 2012 at 09:25:41 AM PST

      [ Parent ]

  •  When I read your title, I thought, "Well, that (6+ / 0-)

    can't be good. Women taking birth control need to be monitored by a physician."

    Would pharmacists take on more health care responsibilities as they did long ago? At one time, pharmacists prescribed and compounded medications for their customers, but things changed with drug companies making medications and doctors prescribing them.

    Now pharmacies are offering the services of nurse-practitioners to customers and giving some inoculations because so many can't afford to go to a doctor. Are doctors now saying that they've been scamming us all these years and that their services weren't necessary to women's health? Or are they abdicating their responsibilities because there's no longer any profit in it?

    "The object of persecution is persecution. The object of torture is torture. The object of power is power. Now do you begin to understand me?" ~Orwell, "1984"

    by Lily O Lady on Wed Nov 21, 2012 at 07:14:29 AM PST

  •  BCP =\= all birth control. (4+ / 0-)
    Recommended by:
    War on Error, weck, entrelac, Catte Nappe

    I don't use birth control pills, myself.

  •  Nobody is doing this. (4+ / 0-)
    Recommended by:
    weck, myboo, VClib, nextstep
    How is it acceptable that they think they have ANY right to dictate the terms of women's bodies?  lives?
    Nobody is "dictating the terms of women's bodies" -- at least not in this fight.  I know of nobody (except maybe some nuts that are not taken seriously by anyone) who is arguing that a women who wants it cannot have birth control.  Nobody is talking about banning birth control. That was settled in the Griswold case decades ago.  
    Women in America FINALLY have access to free birth control,
    There is no such thing as "free birth control" unless you are talking about the so-called "natural methods" like abstaining or the rhythm method.  When you are talking about the birth control pill, it's not "free" and cannot be "free."  Somebody has to pay for it.  The fight is not over whether women can have it, but instead over who has to pay for it when a particular woman wants it.  

    Frankly, making it over the counter (perhaps to women who are legally adults, and with proper warnings so that, just like in many other OTC drugs, the consumer can evaluate the risks) eliminates the problem, I think.  Women who want it would be the ones to pay for it, like any other OTC drug.  No employer would have any say (or any knowledge) over whether a woman takes it.  And no religious based institution (like a Catholic school) would have to pay for something that violates its religious beliefs.  

    •  Those nuts aren't as rare as you'd like to (3+ / 0-)

      believe. I mean, seriously, that's an awfully naive argument considering that it took legal measures to get insurance companies to pay for birth control.

      •  that's a "who is going to pay for it" (3+ / 0-)
        Recommended by:
        VClib, War on Error, nextstep

        argument:

        It it took legal measures to get insurance companies to pay for birth control.
        Since 1965, it has been the law of the United States that no government can pass any law that prevent a woman from getting birth control.  That's based on the "right to privacy" that the SCOTUS found existed in that case.

        But saying that government can't interfere with your exercise of your right is NOT the same as saying you don't have to pay to exercise your right.  I have a  constitutional right to publish an ad in the newspaper, or publish a book, or make a big sign, stating my political beliefs.  That is because the First Amendment prohibits the government from interfering in my exercise of that right.  But nobody says that I'm constitutionally entitled to do those things without having to pay the associated costs.  Same with abortion.  

        And if the government thinks I have a constitutional right to exercise my constitutional right without having to pay for it, then it's up to the government to alleviate those costs (as they do for an attorney if a criminal defendant cannot afford one).  Here, the question is not whether the individual can get birth control, or whether the government should bear the costs if an individual who wants birth control cannot afford it.  The question is whether the government can force another private citizen -- or, most notably, a church (as in the case of a Catholic-run school, for example -- to pay for that birth control either by being self-insured (which is the biggest problem) or by buying an insurance policy that includes that as part of the product they are paying for.

    •  Those catholic orgs are (0+ / 0-)

      Paying for contraception anyway.  They pay dollars, she takes the dollars and buys contraception.  

      •  That's not economically correct. (2+ / 0-)
        Recommended by:
        erush1345, VClib

        The employer is paying for the employee's work.  That's how the economic transaction works.  The employee provides her time and services to the employer, and the employer pays an agreed-upon amount.  Nothing legally, ethically, or morally ties the employer to the employee's choice of how to spend the money after it is paid the to employee.

      •  You are assuming they don't have something (0+ / 0-)

        in their employment contract that prohibits using funds from that job to buy birth control.

        You have watched Faux News, now lose 2d10 SAN.

        by Throw The Bums Out on Wed Nov 21, 2012 at 09:19:37 AM PST

        [ Parent ]

        •  Really? You think something like this exists? (1+ / 0-)
          Recommended by:
          VClib
          something in their employment contract that prohibits using funds from that job to buy birth control.
          I've never ever seen anything in an employee's contract that limits what an employee can buy with his or her own money. Unless maybe its a classified position with security clearance, and the limits affect national security.  But other than that, I can't imagine any situation where an employment contracts says something like, "the employee is prohibited from using funds earned in this job to buy x." No employer -- not even Catholic employers -- do that.  And I can't imagine it would even be legal.  
          •  I wouldn't be surprised though I don't know (0+ / 0-)

            how well it would hold up in court.  Remember, these are not "rational business owners" were are talking about and quite a few of them would rather go bankrupt if they don't get their way.

            You have watched Faux News, now lose 2d10 SAN.

            by Throw The Bums Out on Wed Nov 21, 2012 at 09:51:11 AM PST

            [ Parent ]

            •  I've been a lawyer for (1+ / 0-)
              Recommended by:
              VClib

              more years than I like to admit -- in a HUGELY Catholic city (New Orleans).  And I've never ever ever ever seen ANYTHING that lets an employer dictate how an employee can spend the employee's own money.  The whole notion is absurd.  

              Most employees don't even have an employment contract. And I can't imagine any employment contract limits what an employee can buy with his or her own money.  

              •  I don't doubt that you haven't seen such a thing (0+ / 0-)

                though I would be surprised if such a thing didn't exist at all.  And the contract would specifically say something like "you may not use hormonal or other "un-natural" forms of birth control and we reserve the right to randomly test for it" since enforcing a looser "where did the money come from" standard is much harder.  Also, that part of the contract could simply be a line or two in the employee handbook under the "drug usage" section.

                You have watched Faux News, now lose 2d10 SAN.

                by Throw The Bums Out on Wed Nov 21, 2012 at 10:19:22 AM PST

                [ Parent ]

                •  TTBO - I don't believe any such language exists (0+ / 0-)

                  in any employment agreement or employee handbook because any company with competent counsel would be advised that such a provision was not enforceable, and likely a violation of state labor laws.

                  "let's talk about that"

                  by VClib on Wed Nov 21, 2012 at 11:54:07 AM PST

                  [ Parent ]

  •  Female middle aged. (5+ / 0-)

    I think it's a good idea to take this out of the doctor's office. An initial doctor visit could suffice to figure out which drug would work better for you, and subsequent visits could be done by a nurse or PA. You could have stores check ID like they do for cigarettes and alcohol.

    "Let us never forget that doing the impossible is the history of this nation....It's how we are as Americans...It's how this country was built"- Michelle Obama

    by blueoregon on Wed Nov 21, 2012 at 07:24:47 AM PST

  •  Good idea (5+ / 0-)

    But I wish the costs could be lowered or subsidized for low-income women.  The low-hormone pills of today have much fewer side effects than the pills of yesteryear.

    Children deserve to be born into situations where they are wanted. An education campaign for proper pill usage would probably be beneficial.

    The Democratic Party stands for equality for ALL, freedom with responsibility, and a civil and just society.

    by TexasLefty on Wed Nov 21, 2012 at 07:25:58 AM PST

  •  having worked in a Midwives office (4+ / 0-)

    Most women choose the IUD and Depo shots. The pill is not dangerous unless you have some medical conditions that would be exacerbated by hormonal bc.

    It is a bad idea to make bc over the counter. Too many health considerations for each individual. This is something that should be carefully considered as pertains to your lifestyle (do you smoke?), health history and risks, and what will you use most effectively?

    The IUD is by far the most popular with the women that generally come into our office. Many Muslim women and their spouses choose the IUD. Many young women that do not want to be bothered with taking oral or coming in for shots use the IUD. I think bc should be readily available and free but not over the counter.

    You only live once, but if you do it right, once is enough. -Mae West

    by COwoman on Wed Nov 21, 2012 at 07:28:37 AM PST

  •  Affordable to whom? (10+ / 0-)

    An extra $69 a month is not affordable to everyone. And you can't just decide to take the cheap ones -- they might not work for you.

    I agree it should be free, but it should be dispensed by licensed medical professionals who have evaluated a woman before she starts. Women should also be monitored while on the pills or IUD.

    And NO birth control method is foolproof except maybe sterilization. I developed a (benign) tumor in one breast from taking certain pills back in the late '70s, and got pregnant with an IUD in place, which required me to have an abortion because the device perforated the fetus and it was no longer viable.

    And one more thing: I can tell you that some women DO like abortions. I sure do. It enabled me to avoid massive medical complications and possibly death or infertility. My neighbor, whose baby died in utero at six months, would have liked to have an abortion too, but her doctors were too chickenshit to give her one and she carried a dead thing inside for three months.

    There is nothing wrong with abortion. It saves lives -- lives of living, breathing women who would die without it. It's a medical procedure, and I wish people (especially men who will never get pregnant) would get over their stupid selves and leave us and our bodies the hell alone.
     

    "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

    by Brooke In Seattle on Wed Nov 21, 2012 at 07:29:00 AM PST

  •  There is no medical reason (3+ / 0-)

    why oral contraceptives should not be over the counter. They are far less risky than many commonly used OTC drugs. For example, aspirin and acetominophen (Tylenol) are so dangerous that they might not be approved as prescription drugs in the current climate. The reasons to keep them prescription only are purely political.

    •  Yeah? How the hell do you know that? (0+ / 0-)

      Have you ever thrown up for 5 days straight on one birth control pill, only to switch to another that worked beautifully based on medical advisement? Aspirin and Tylenol are only dangerous when misused; that isn't necessarily the case with birth control pills. And that's not much of an argument- something else is riskier, so the risks of birth control should be ignored. Does not compute.

      Y'know, despite what the author has to say, I really don't want to hear what women should do with their bodies from men who are not professionals.

  •  OTC birth control is a benefit only to Big Pharma. (5+ / 0-)

    They won't be lowering the price, and health insurance will no longer cover it.  Hormones aren't cheap.

     If they are going to let drugs be sold over the counter, why not have all drugs sold over the counter?  Why NOT?  Because hormones may not be appropriate for some women.  Because a doctor needs to regulate how much warfarin affects the user.  Because insulin can kill.  Because viagra would be abused. Because too much penicillin creates superbugs. Because teenagers would die.

    They end up putting the drug back behind the counter, like ephedrine, and making it the pharmacist's responsibility instead of a doctor's.

    There is only one reason to make it over the counter, and that is because there is money in it for somebody, and the doctors are doing what Big Pharma told them to do.

    Please donate to Okiciyap food pantry. . If love could have saved you, you would have lived forever.

    by weck on Wed Nov 21, 2012 at 07:44:53 AM PST

  •  Mixed opinion (3+ / 0-)

    On the one hand, I don't want people to forego free pills because they can't afford (or find) a doctor visit to get the prescription. Planned Parenthood (YAY!!!) and clinics with sliding scale can solve that, if they are available.

    But I also think the decision on what type of birth control is best, given the person's situation, deserves a consultation with a trained medical person, especially the first time around though maybe not every year. It gives the health practitioner (nurse or NP, or even peer worker) a chance to counsel on safe sex (to prevent disease, not pregnancy), recognizing unsafe situations or abusive ones, the importance of taking the pills as prescribed, and whatever else is going on in the person's life.

    And there are health hazards, especially for women with pre-existing high blood pressure and some other conditions -- I'm not keen on hormones of any kind being OTC.

    I am female, long past the birth control age (and got my tubes tied in my mid-30s after my 2 kids). I am old enough to remember when the Pill first became easily available, but many doctors were reluctant to give prescriptions to single women.

  •  this would be about shifting costs to the (5+ / 0-)

    consumer and not about delivering good healthcare. This is the same crap that happened with 2nd-generation non-sedating antihistamines. Once Claritin went OTC, insurance companies immediately dropped coverage for non-OTC alternatives, despite known differences in effectiveness and indications. Claritin owned the OTC market for awhile at $1-$2 a pill until generics came along. This move cost me hundreds of dollars until Allegra was approved for OTC years later.

    The exact same would happen for birth control. The second one brand/formulation is approved for OTC use, the insurance companies would immediately unburden themselves from covering ANY birth control. If your preferred drug stays in the prescription-only tier, you are not going to be paying the prices shown above. You'll be paying full freight, which will be whatever the pharmacy decides it can charge and the insurance company won't pay a nickel.

  •  Middle-aged white guy here (0+ / 0-)

    and while I've been brought up to think that the Pill is supposed to be monitored closely, if OB-GYNs think differently, I'll take their words for it.

    Hige sceal þe heardra, heorte þe cenre, mod sceal þe mare, þe ure mægen lytlað

    by milkbone on Wed Nov 21, 2012 at 07:59:37 AM PST

  •  You would expect that women (1+ / 0-)
    Recommended by:
    Magenta

    Would be monitored if the medication is dangerous.  But what does that monitoring actually consist of?  The doc asks if you have any problems, or any questions.  It's not so much monitoring as an offer of counseling.  Plus co pay for the visit.

    •  Hormones are powerful drugs (1+ / 0-)
      Recommended by:
      gramofsam1

      They should not be self-prescribed.

      If a woman has breakthrough bleeding, migraines or, heaven forbid, a clotting disorder like Factor V Leiden that doesn't generally cause a problem until hormones are introduced with BCP's or pregnancy what then? How many women will just try a different brand and not talk to their doctor.

      Right now they have to see their doctor if they want to switch and they have to describe why. This removes that step in possibly catching an issue.

      Right now women also have to have their yearly PAP to get their prescriptions renewed. How many women will skip that unpleasantness if they have no reason to go?

  •  I'm not a fan of OTC on any hormone-based meds (2+ / 0-)
    Recommended by:
    entrelac, gramofsam1

    It is really easy to mess yourself up with the wrong dose, and birth control meds in particular vary widely in the mix and amount of hormones.

    You want a doctor involved in the decision, one who knows all the other meds/herbs/etc you are taking and also any other risk factors (eg, smoking) that can dramatically increase the risks of certain kinds of birth control.

    So I wouldn't recommend OTC birth control any more than I'd recommend OTC Thyroid replacement meds.

  •  Clarification - OTC hormonal birth control (2+ / 0-)
    Recommended by:
    War on Error, Catte Nappe

    is what I object to.   (white male whose wife uses a specific formulation pill, after over a decade of strictly using condoms rather than deal with potential health issues)

    But it isn't like there are a lot of other types that aren't already over the counter except....

    IUD needs a professional to install

    Diaphram needs a professional to help fit it properly, or it won't work.

    So...I don't see a role for OTC in birth control that it isn't already doing.

  •  The issue of relative public health risk (1+ / 0-)
    Recommended by:
    blueoregon

    is something for the FDA and experts in public health to assess.

    The ACA regulation requiring contraceptive coverage is a good step in the right direction, but there is a rather large gap in how that regulation will facilitate access for women to contraceptives.

    For any woman dependent on someone else for their insurance plan, that policy holder will automatically know whether his/her wife or daughter is using contraceptives.

    That means that a young woman up to age 26, who is on her parents plan, may forgo that medical benefit if it would mean her parents find out she is sexually active.

    That means that a married woman who doesn't want to have more children may forgo the medical benefit of contraceptives if her husband would punish her for it.

    Some hormonal contraceptives have been used safely by millions of women over many years. The safest among them could be made available in a restricted OTC manner. Something like the restrictions on allergy medicines that used to be prescription only, and are now OTC, but ID is required and your purchases are recorded by the pharmacy.

    I voted yes, but would restrict OTC availability in the following ways:

    1. Initial OB/Gyn consultation required - script with 2 refills.
    2. 90 day follow-up OB/Gyn consultation required - script with 11 refills.
    3. Annual OB/Gyn consultation - if doc says ok, OTC available without a doctors visit, for that person only.
    4. The purchaser of OTC contraception should still have to give name/license with each purchase.  

    That gate is necessary to prevent a black market, where adults are buying OTC contraceptives for minors, or others who have had no individual medical consultation, (such as women who were coerced into prostitution).

    •  Wow (0+ / 0-)

      You are actually making it MORE burdensome than it currently is.  

      None of this concern about people supposedly having horrid side effects is based in medical fact or best practices.

      •  I guess my No. 3 isn't written clearly (0+ / 0-)

        I meant to say that after initial medical consultation, and with follow-up after a reasonable number of cycles, that woman can be trusted to know if there are any problems she needs to call her doctor about, and should have access to monthly renewal without having to see a doctor annually.

        The problem with straight OTC is access by minors, either by their own choice or by someone in a position to coerce a girl  or a woman to take hormonal contraceptives to prevent pregnancy (e.g. pimps, sex slave masters, perpetrators of incest).

      •  I do think there needs to be an affordable (0+ / 0-)

        option outside of insurance coverage.

        A young woman on her parent's insurance policy (who may be deeply religious), shouldn't have to go through them for birth control. There's too much at stake.

        A woman of any age, in an abusive situation, should be able to get contraceptives, and prevent pregnancy, with out the person who has the insurance policy holders' oversight.

  •  to dangerous (1+ / 0-)
    Recommended by:
    gramofsam1

    I expect eventually BC will go over the counter because that way insurance companies don't have to pay for them. They did the same thing with allergy meds like claritan, made over the counter and Insurance companies got out of paying for them.
    BC pills can cause blood clots and major complications and need to be taken under a doctors care. Still never underestimate the drug companies power.

  •  Emotional decision? (1+ / 0-)
    Recommended by:
    War on Error
    people feel that they have no right to dictate this emotional decision for others.
    No, this is a necessary right for life, health, and economic reasons. Relegating it to the realm of emotional decision-making delegitimizes it.
  •  The side effects outweigh the benefits (1+ / 0-)
    Recommended by:
    entrelac

    A woman needs to see a doctor

  •  I'm against making it over the counter (1+ / 0-)
    Recommended by:
    entrelac

    for a couple of reasons.

    1) Pills do have a wide variety of side effects, from mood swings to hypertension, and yearly monitoring is a good idea.  If one kind of pill doesn't work for you, then you'd want to try another, and a doctor's advice is useful there.

    2) Making it an OTC drug that women have to pay for is a problem. The bottom line is that women can't get pregnant by themselves, and there's zero reason they should pay more than half of the costs of their birth control. When the price is carried by everyone who has insurance, then it's a fairer burden on women.

    3) I don't want to see hard-core b/c pill advertising directed at women.  It's bad enough that it's directed at doctors. Expecting women to make informed decisions when they're being overwhelmed by ads that play no their emotions is a bit too much.

    4) Lots of women take b/c pills to regulate their hormones, and those women should see a doctor before doing so.

    "If you fake the funk, your nose will grow." -- Bootsy Collins

    by hepshiba on Wed Nov 21, 2012 at 11:34:00 AM PST

  •  It's a GREAT idea! (0+ / 0-)

    I read long ago that, judging from what we know about cigarettes and what we know about birth control pills, we should make birth control pills available over the counter and cigarettes available ONLY with a doctor's prescription.

    Any danger a girl faces from taking a birth control pill PALES besides the dangers of dying from a botched illegal abortion or death in childbirth--yes, that still happens.  Ectopic pregnancies happen too.

    I'm all for it!

    "Religion is what keeps the poor from murdering the rich."--Napoleon

    by Diana in NoVa on Wed Nov 21, 2012 at 12:38:41 PM PST

  •  usually when things go OTC (0+ / 0-)

    they become lest costly. Like Allegra for example, that was incredibly expensive.

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