Abstract
Background
A progestin-only pill may be the first pill formulation to become available over the
counter in the United States; however, no research on over-the-counter (OTC) pill
interest has focused on progestin-only pills or a representative sample of teens.
The objective of this study was to assess U.S. women and teens’ interest in OTC progestin-only
pill use.
Methods
In October 2015, we conducted a nationally representative, cross-sectional, online
survey with 2,026 sexually active adult women aged 18 to 44 not currently desiring
pregnancy, and 513 female teens aged 15 to 17. Logistic regression was used to identify
characteristics associated with likely OTC progestin-only pill use. We also assessed
reasons for use or nonuse, duration of use, and willingness to pay.
Results
Thirty-nine percent of adults and 29% of teens reported likely use, with a greater
likelihood if covered by insurance. Adults were willing to pay $15 per month and teens
$10 per month on average. Among adults, women who were never married or living alone
(vs. married), uninsured (vs. privately insured), current pill or less effective method
users (vs. ring, patch, injectable, or intrauterine device), tried to get a birth
control prescription in the past year, or ever used an oral contraceptive pill or
progestin-only pill had higher odds of likely use. Among teens, Spanish speakers and
those who ever had sex had higher odds of likely use; Black teens (vs. White) had
lower odds.
Conclusions
Teens and adults are interested in using an OTC progestin-only pill. These findings
indicate a large pool of interested users and the potential for improved contraceptive
access by making an OTC progestin-only pill available.
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References
- Over-the-counter oral contraceptives.(Available:) (Accessed: May 1, 2017)
- Committee opinion no 544: Over-the-counter access to oral contraceptives.Obstetrics & Gynecology. 2012; 120: 1527-1531
- Committee Resolution D-75.995: Over-the-counter access to oral contraceptives.2013 (Available:) (Accessed: May 1, 2017)
- Maryland takes birth control coverage to the next level.2016 (Available:) (Accessed: May 1, 2017)
- Current Population Survey supplement data.Author, Washington, DC2014
- Computing response metrics for online panels.Public Opinion Quarterly. 2008; 72: 1008-1031
- A critical review of studies investigating the quality of data obtained with online panels.in: Callegaro M. Baker R. Bethlehem J. Göritz A. Krosnick J.A. Lavrakas P.J. Online panel research: A data quality perspective. John Wiley and Sons, New York2014
- National survey of family growth. 2011–2013 NSFG: Public use data files, codebooks, and documentation.(Available:) (Accessed: May 1, 2017)
- US medical eligibility criteria for contraceptive use, 2016.Morbidity and Mortality Weekly Report. 2016; 65: 1-104
- Annual update of the HHS poverty guidelines.Federal Register. 2015; 80: 3236-3237
- Declines in unintended pregnancy in the United States, 2008–2011.New England Journal of Medicine. 2016; 374: 843-852
- Prescription requirements and over-the-counter access to oral contraceptives: A global review.Contraception. 2013; 88: 91-96
- Prescription birth control access among U.S. women at risk of unintended pregnancy.Journal of Women's Health. 2016; 25: 249-254
- Over-the-counter access to oral contraceptives.Obstetrics & Gynecology Clinics of North America. 2015; 42: 619-629
- Accuracy of self-screening for contraindications to combined oral contraceptive use.Obstetrics & Gynecology. 2008; 112: 572-578
- Perceptions of the safety of oral contraceptives among a predominantly Latina population in Texas.Contraception. 2010; 81: 254-260
- Interest in over-the-counter access to oral contraceptives among women in the United States.Contraception. 2013; 88: 544-552
- Reproductive health preventive screening among clinic vs. over-the-counter oral contraceptive users.Contraception. 2012; 86: 376-382
- Health insurance coverage among women of reproductive age before and after implementation of the Affordable Care Act.Contraception. 2016; 93: 386-391
- KnowledgePanel® design summary.2013 (Available:) (Accessed: May 1, 2017)
- Birth control within reach: A national survey on women’s attitudes toward and interest in pharmacy access to hormonal contraception.Contraception. 2006; 74: 463-470
- User characteristics and out-of-pocket expenditures for progestin-only versus combined oral contraceptives.Contraception. 2012; 86: 666-672
- A national survey of women's attitudes toward oral contraception and other forms of birth control.Women's Health Issues. 1995; 5: 94-99
- Will insurance cover an OTC birth control pill?.(Available:)http://ocsotc.org/faqs/#ImpactofHCR(Accessed: May 1, 2017)Date: 2016
- Continuation of prescribed compared with over-the-counter oral contraceptives.Obstetrics & Gynecology. 2011; 117: 551-557
- Clinic versus over-the-counter access to oral contraception: choices women make along the US-Mexico border.American Journal of Public Health. 2010; 100: 1130-1136
- Agreement between women's and providers' assessment of hormonal contraceptive risk factors.Contraception. 2006; 73: 501-506
- Impact of the federal contraceptive coverage guarantee on out-of-pocket payments for contraceptives: 2014 update.Contraception. 2015; 91: 44-48
- Contraceptive failure in the United States.Contraception. 2011; 83: 397-404
- American Community Survey.United States Census Bureau, Washington, DC2013
- Over-the-counter access to oral contraceptives for adolescents.Journal of Adolescent Health. 2017; 60: 634-640
- Medicaid coverage of family planning benefits: results from a state survey.(Available:) (Accessed: May 1, 2017)
- Contraindications to progestin-only oral contraceptive pills among reproductive-aged women.Contraception. 2012; 86: 199-203
- Comparing the accuracy of RDD telephone surveys and internet surveys conducted with probability and non-probability samples.Public Opinion Quarterly. 2011; 75: 709-747
Biography
Kate Grindlay, MSPH, is an Associate at Ibis Reproductive Health and Project Director of the Free the Pill project. She oversees the implementation of a program to move an oral contraceptive pill over the counter in the United States.
Biography
Daniel Grossman, MD, is the Director of Advancing New Standards in Reproductive Health at the University of California, San Francisco. His research focuses on improving access to contraception and safe abortion and evaluating the impact of integrating reproductive health and HIV services.
Article info
Publication history
Published online: January 29, 2018
Accepted:
November 20,
2017
Received in revised form:
November 10,
2017
Received:
May 15,
2017
Footnotes
Funding Statement: Supported by The David and Lucile Packard Foundation (grant number 2015-63012) and The William and Flora Hewlett Foundation (grant numbers 2012-7908, 2015-2997). The funders had no involvement with the study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the report for publication.
Identification
Copyright
© 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc.
