title: Over-the-counter access to oral contraceptives as a reproductive healthcare strategy.
abstract: OBJECTIVE
  The aim of this review is to summarize the current evidence on the safety and effectiveness of moving oral contraceptives from prescription-only to over-the-counter (OTC) status. The review also examines women's interest in OTC access to oral contraceptives, as well as potential barriers and facilitators to an OTC switch.
  
  
  RESULTS
  Studies show that women can safely self-screen for contraindications to oral contraceptives - especially progestin-only pills - without the aid of a clinician. One study in Texas found that women using pills obtained OTC in Mexico were significantly less likely to discontinue compared to women obtaining pills at US clinics by prescription. A national representative survey of US women at risk of unintended pregnancy found widespread interest in using OTC pills, and many women worldwide already have access to pills without a prescription. On average, the most US women report being willing to pay for an OTC pill is $20.
  
  
  CONCLUSIONS
  OTC access to oral contraceptives could help to reduce unintended pregnancy by increasing the number of pill users, improve continuation and reduce gaps in use. It is critical that a future OTC pill be made available at an accessible price, and it should be covered by insurance without a prescription. Research suggests that common concerns about the safety of oral contraceptives OTC and a potential negative effect on women's use of preventive services are largely unsupported.
authors.affiliation: aIbis Reproductive Health, Oakland bBixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.forename: Liza
authors.initials: L
authors.lastname: Fuentes
mesh_terms: D003257:Consumer Product Safety / Q000592:standards*; D003276:Contraceptives, Oral / Q000191:economics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D004366:Nonprescription Drugs / Q000191:economics; D010353:Patient Education as Topic; D014481:United States; D014932:Women's Health Services / Q000639:trends
chemical_list: D003276:Contraceptives, Oral; D004366:Nonprescription Drugs