BC without a prescription? A way around free pills?

[Buzzard]

http://www.ajc.com/ap/ap/top-news/obgyn ... lls/nTBrq/

I'll admit I was confused by the discussion in the Hobby Lobby thread about the morning after pill being free post 1/1/13 because its OTC, which means I have to pay for it under my current prescription plan. This article is timely because, it seems, this may be a way to allow the "religious objectors" to cover their employees without ponying up for the pill.

Then there's the price question. The Obama administration's new health care law requires FDA-approved contraceptives to be available without copays for women enrolled in most workplace health plans.

If the pill were sold without a prescription, it wouldn't be covered under that provision, just as condoms aren't, said Health and Human Services spokesman Tait Sye.

I'm confused by the reasoning because my understanding of the new law would require the annual exams to be free but:

Many women have trouble affording a doctor's visit, or getting an appointment in time when their pills are running low — which can lead to skipped doses, Nanda added.

If the pill didn't require a prescription, women could "pick it up in the middle of the night if they run out," she said. "It removes those types of barriers."

Backdoor plan?

[Sunnichick31]

I'm against BC without a perscription. My main concern would be possible interactions with other medicines, so I do think that a woman should consult a doctor, or at least a pharmacist to make sure that it's safe to take.

[Rowan]

I'm against BC without a perscription. My main concern would be possible interactions with other medicines, so I do think that a woman should consult a doctor, or at least a pharmacist to make sure that it's safe to take.

Agreed. You are changing your body's hormones and that's not something that should be messed around with by someone who really doesn't have a clue how that can affect so much else.

[sassycupcake]

Agreed. BC can also cause spikes in blood pressure and/or serious blood clots, especially in older women who smoke. These are easily detected, but only if you're seeing a doctor. Undetected, they can cause major problems.

[mockingbird]

There are so many, too - not just methods but then different types/brands of each one. I think it's good to have a trained professional help you sort through the options.

[gimlet]

Well, and note the irony: they've been discussing having the pill (or even Plan B style pill packs) OTC for 15 years or more, but it never gets approved because of the concerns about strokes and clots and women taking them without consulting a doctor. Now they'd approve the Pill OTC so employers wouldn't have to cover it because of religion? I laugh bitterly at that. It's never really care for women that is the impetus for these moves.

[SealFan1963]

Agreed. BC can also cause spikes in blood pressure and/or serious blood clots, especially in older women who smoke. These are easily detected, but only if you're seeing a doctor. Undetected, they can cause major problems.

My husband used to work with stroke victims and they would see at least one young woman a month (under 35) that had had a stroke because she took the pill and smoked. It is more common than people think.

[SealFan1963]

I wonder if Hobby Lobby has objections to covering Viagra? Or a diaphragm?

[Sola]

You can get the morning after pill OTC here in the UK. You have to have a quick consult with the pharmacist, but that's it. Its been that way for around twenty years or more.

[miffy]

^Its OTC in Australia too.

Apparently there is a new law that a pharmacist will give you BC without a script if you have run out, but are currently being prescribed the medication.

AFAIK the mini pill is quite safe & has few contradictions. But the combined pill has a lot of contradictions. I take Yasmin at my own risk because I've had a few migraines with aura.

[emmiedahl]

The morning after pill is OTC in the US for people ages 17 and over.

I do think hormonal contraceptives should be available only by prescription, or at least certain ones. Due to a health condition, I cannot take the ones with estrogen and I would not have known this without a doctor consulting. I considered taking a hormonal contraceptive even though we had my husband snipped, because bc treats other issues. But the estrogen pill is the one that treats those issues so I am SOL. Good thing I had a doctor to tell me that my extreme migraines are not compatible with that pill or I might have another health issue I don't understand.

[Buzzard]

Well, and note the irony: they've been discussing having the pill (or even Plan B style pill packs) OTC for 15 years or more, but it never gets approved because of the concerns about strokes and clots and women taking them without consulting a doctor. Now they'd approve the Pill OTC so employers wouldn't have to cover it because of religion? I laugh bitterly at that. It's never really care for women that is the impetus for these moves.

I agree. The timing of this is a bit too convenient. I'm very opposed to this being OTC. There are 70000000000000000000000 different brands, generics, compounds, strengths etc. I can only imagine a teenager walking into CVS and staring at a row of options and not knowing how to make the choice. Doctors need to work with a woman to determine which is right for her and her medical condition. I call BS on the "availability" argument and the "too expensive to see a dr" argument. PP and many other women's health centers are available to do an annual if its a financial issue, and that hurdle will be removed with the implementation of the ACA in january. But for the fact that I MUST get an annual to get my prescription I think that I would skip it which may have a detrimental impact on my health in the long run, and theres no way I'd be alone skipping the pap and other important screenings since its no longer "mandatory."

This is economics. Whether its insurance companies, pharmacies, or employers (or all 3) that dont want to eat the cost of free BC, this has nothing to do with women's health and accessibility. This is pure "we dont want to pay for it."

[Katiebug]

I agree that hormonal contraceptives should require a prescription due to the risk of blood clots and strokes, especially in certain high risk groups. I know [link=http://www.cnn.com/2012/11/20/health/birth-control-over-the-counter/index.html?hpt=hp_t2]ACOG is recommending OTC sales[/link] and has for some time (and who am I to presume I know better than a bunch of doctors?) but I wonder if women would really screen themselves out if they had known risk factors. I had a college roommate (a very bright young woman studying engineering) who lied about her pack-and-a-half-a-day smoking habit in order to get her birth control prescription. I have no issue with Plan B being available OTC, because it's a single/double dose not meant to be taken long-term and has been found to be unlikely to cause the same issues as can daily exposure to the hormones in the Pill.

I think doctors in the US are generally advocating for more reliable methods of contraception. When I went in for my annual a few months ago I got to fill out a form asking about the time frame of any future childbearing and about interest in long term reversible contraceptives as well as surgical or non-surgical sterilization. My OB doesn't push one thing over another, but he does offer those options and wants to make sure patients are educated about what's available. I might ask him at my next prenatal appointment what he thinks of the idea of OTC birth control pills - now I'm curious!

As usual with the religious right, something that would reduce the number of unplanned pregnancies - and abortions - will be screamed about because it will allow people to have sex with fewer consequences. I also think there's likely a healthy dose of "we don't want to pay for those sluts who should be keeping their legs together."

[Kaylee]

AFAIK the mini pill is quite safe & has few contradictions. But the combined pill has a lot of contradictions. I take Yasmin at my own risk because I've had a few migraines with aura.

Isn't it also the least effective though?

After I had my son, my midwife prescribed the mini-pill because she wanted me to wait 18 months before getting pregnant again (I needed a c-section and planned on a VBAC if I got pregnant again, so that gave things time to heal). She said to come back to see her for a stronger/different form of BC if I started having regular periods or stopped nursing during the time frame, because the mini-pill was not as effective as some of the other types.

[Austin]

No one should smoke if they take the pill. Doctors and all the packaging information are pretty clear about that. Everything has risks, but the risks with BC pills are greatly magnified by smoking. If a woman didn't have to see a doctor to evaluate if the pill is a good choice for her she may not know that, as most people really do not read package inserts.

[Buzzard]

No one should smoke if they take the pill. Doctors and all the packaging information are pretty clear about that. Everything has risks, but the risks with BC pills are greatly magnified by smoking. If a woman didn't have to see a doctor to evaluate if the pill is a good choice for her she may not know that, as most people really do not read package inserts.

I can just see the commercials now. A woman dancing in a field of daffodils, spinning in circles, talking about how much she loves her one pill a day... then a tiny list of things no one could read as the contraindications briefly flashes on a screen...

[gnegirl]

Agreed. BC can also cause spikes in blood pressure and/or serious blood clots, especially in older women who smoke. These are easily detected, but only if you're seeing a doctor. Undetected, they can cause major problems.

You don't have to be a smoker, I wasn't and had this side effect.

If you are on the pill and > 40, check your blood pressure regularly.

[Maggie Mae]

I don't think most medication should require a prescription. I know perfectly well what contacts I need, yet I have to go get an eye exam every year and I can't try out new brands without going in and forking over a ridiculous amount of money to someone I talk to for two seconds.

I know when I have a cold and when I have the flu and when I have strep throat and I know perfectly well what medication they will prescribe me if any and how much. I know what kind of bc to use. I don't think I should have to give more money to someone I don't know so they can give me a piece of paper that gives me permission to buy medication. It's ridiculous. I understand that people need to see a doctor regularly to check on stuff that most people don't know about or might overlook, but when I get strep, I don't want to call the doctor, schedule an appointment for days later, wait, get to the doctor, wait an hour or two, have them look at my throat for two seconds, tell me it's strep and that I might want to consider having my tonsils out, write me a prescription, drive to the pharmacist, wait an hour, pay more money, and then go home. I would love to be able to wake up, be like "oh, crap, it's strep again" , go to the store, buy some medicine, and then go home and go to bed. Thus cutting days off of my being sick.

I have to fill out a card and show ID every time I buy cold medicine, why can't we do that with controlled medications?

I've never had any medication covered by insurance, so I am probably a little biased here.

[JenniferJuniper]

I don't think most medication should require a prescription. I know perfectly well what contacts I need, yet I have to go get an eye exam every year and I can't try out new brands without going in and forking over a ridiculous amount of money to someone I talk to for two seconds.

I know when I have a cold and when I have the flu and when I have strep throat and I know perfectly well what medication they will prescribe me if any and how much. I know what kind of bc to use. I don't think I should have to give more money to someone I don't know so they can give me a piece of paper that gives me permission to buy medication. It's ridiculous. I understand that people need to see a doctor regularly to check on stuff that most people don't know about or might overlook, but when I get strep, I don't want to call the doctor, schedule an appointment for days later, wait, get to the doctor, wait an hour or two, have them look at my throat for two seconds, tell me it's strep and that I might want to consider having my tonsils out, write me a prescription, drive to the pharmacist, wait an hour, pay more money, and then go home. I would love to be able to wake up, be like "oh, crap, it's strep again" , go to the store, buy some medicine, and then go home and go to bed. Thus cutting days off of my being sick.

I have to fill out a card and show ID every time I buy cold medicine, why can't we do that with controlled medications?

I've never had any medication covered by insurance, so I am probably a little biased here.

I've always been somewhat of a libertine when it comes to drugs, and I think you make a lot of sense.

For routine things like birth control why are we required to regularly sit in a doctor's office for ages and then hope we can find a pharmacy that agrees with dispensing a prescribed drug?

Ultimately we're all responsible for the one body we each have, and we should learn to take responsibility for everything we consume, understanding what potential side effects might occur and what interactions with food, alcohol and other drugs might happen, instead of hoping a third party will take care of all that for us. If I were queen, I'd set up a regulated on-line service for routine health matters where you can put in all of the necessary health and drug history information and receive back recommendations you can then use to buy your medication off the shelf. No judgments, no questions asked. Show your ID, the info is logged into your health profile, and you sign a waiver indicating you know what you are buying.

Would people lie? Sure, but they lie to doctors too. Just like they can steal meds or buy them illegally if they so choose. But if we really want to get people to take responsibility for their own health, maybe it's time to let them have some basic responsibility for decisions regarding routine health matters. Not to mention the fact that we'd save a hell of a lot of money in unnecessary medical visits and that savings could be used to help subsidize drug costs.

[Austin]

You don't have to be a smoker, I wasn't and had this side effect.

If you are on the pill and > 40, check your blood pressure regularly.

The literature nor anyone's doctor would ever say that the only time you can have this or any reported side effect of oral contraceptives is if you smoke, but the chances are raised considerably if you do, that's all.

I am in my late 40s, still take oral contraceptives, and certainly have my BP checked regularly. It is fine, even a bit low, as it has been all of my life. I am in reasonably good shape otherwise and have never smoked, but would never assume I couldn't have a side effect.

[StarrieEyedKat]

I just skimmed the thread since I'm in the midst of holiday baking, but as far as getting around insurance paying for B.C. if it's made OTC - you can still get a prescription for OTC meds so that insurance pays for it. My husband takes allergy medicine and stuff for heartburn - both are typically OTC but his doctor writes a script for him so that it will be covered by our insurance.

[dawbs]

there are dangers from the pill...but really, there are dangers to a lot of 'old' meds that are OTC. I don't tend to think the dangers from the pill are significantly greater than the dangers of OTC pain pills.

And I'd think the risks from 'oops, pregnant!' affects the math even more.

(and what starrieeyedkat said also makes sense--I have $5 worth of perscription motrin in my purse because the doc knows I need it often and wanted to save me from buying advil all the time)

[bbtlover]

When I was taking BC, all of the different pills prescribed to me by the doc, the pills made my heart skip beats, raise my blood pressure, feel jittery, and have strange emotional out bursts. If I had gotten this over the counter, I probably would have kept trying different brands until I had some major health problems. When I told my doc. about the symptoms, he told me that my best bet for BC would be an IUD without hormones. He also said that he had heard of those complaints from other patients and so that he really didn't like yaz, yasmin for those reasons. I had very few problems with Nuvaring though (only problem was no libido :(). I could not stand life like that anymore, so I stopped using it.

[Alecto]

Maybe a nice middle ground would be you don't need to CONTINUE to see a doctor to get birth control? The doctor can simply write you a prescription once.

[ElphabaGalinda]

Maybe a nice middle ground would be you don't need to CONTINUE to see a doctor to get birth control? The doctor can simply write you a prescription once.

I really like that idea. I think you should definitely get a prescription in the first place to talk about risks and side effects, and if it's the best method of birth control for you and how it might affect any of your other medications/unique medical issues. But once you have one prescription, I don't think you should need to go back to the doctor for another one. You can go if you have any side effects of if anything changes.

My mother had a very serious blood clot from birth control when I was a kid, and couldn't take it since, which is why I was very thorough in my appointment when I got my first prescription for the pill. And my mother never smoked in her life and was about 35. So the side effects scared me. But having to keep getting prescriptions is a pain, and I don't think it's necessary.