The recent birth control kerfluffle has brought to light a lot of the ridiculous rules and general hassle associated with getting and filling a prescription for hormonal birth control. Mother Jones points to a piece by Virginia Postrel about why pills should be over the counter, and why they are not. According to a 1993 editorial in American Journal of Public Health, “more is known about the safety of oral contraceptives than has been known about any other drug in the history of medicine.”
So why not make them OTC? Aside from the wailing and rending of garments the hard-line anti-choicers would subject us to, it’s because ladies are considered too stupid to go in for an annual pap smear unless they are forced to by withholding their birth control:
Aside from safety, the biggest argument for keeping birth-control pills prescription-only is, to put it bluntly, extortion. The current arrangement forces women to go to the doctor at least once a year, usually submitting to a pelvic exam, if they want this extremely reliable form of contraception. That demand may suit doctors’ paternalist instincts and financial interests, but it doesn’t serve patients’ needs.
The piece raises another question that has always bugged the crap out of me, which is why are pills dispensed only in little one-month allotments, or at the most, three months, if you’re ordering from an online pharmacy? I was talking to a Canadian friend stuck here and she was so confused by our birth control pill system—apparently at home she just gets handed 12 pill packs for zero dollars. Here she has to go back to the pharmacy every single month and re-pay the co-pay for a single pack of pills.
Even the most responsible citizen screws up once in a while and ends up away from her pharmacy when the pill pack runs out and then has to scramble for a refill/cross her fingers for a few days. Science shows that letting people have their pills all at once decreases accidental pregnancies:
This gibes with another study done in California that compared continuous use of contraceptives among women who got monthly supplies vs. women who got yearly supplies. Over the following 15 months, the women who got yearly supplies were less likely to run out, less likely to get pregnant, and less likely to have an abortion.
So why not do it that way? Because that’s not the way it’s done. Insurance companies don’t do it that way, so you can’t have it that way. The end. Who cares what is easiest and most effective for patients, right?