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OTC Oral Contraceptive Pills Improve Access to Effective Contraception

OTC access linked to 31.8 percentage point increase in individuals moving from no contraceptive method to an effective method

By Elana Gotkine HealthDay Reporter

THURSDAY, Aug. 21, 2025 (HealthDay News) — The newly available over-the-counter (OTC) progestin-only oral contraceptive pill (OCP) is accessed by individuals who use no method or less-effective methods of contraception, according to a study published online Aug. 18 in JAMA Network Open.

Maria I. Rodriguez, M.D., M.P.H., from Oregon Health & Science University in Portland, and colleagues conducted a cross-sectional study using baseline data from a national, prospective U.S. cohort to examine whether the newly available OTC progestin-only OCP is reaching individuals not previously using contraception. Participants, aged 15 to 45 years, obtained OCPs at pharmacies or online between April 2024 and February 2025.

The sample included 986 individuals, who were mainly single (70.2 percent) and mostly aged 20 to 24 years (34.3 percent). OTC OCP users accounted for 32.5 percent of all participants. The researchers found that compared with prescription users, OTC OCP users were more likely to be uninsured (31.6 versus 3.5 percent) and to reside in rural areas (14.4 versus 8.4 percent). Fertility preferences did not differ between the groups. Compared with prescription OCP users, OTC use of contraception was associated with a 31.8 percentage point increase in moving from nonuse of contraception to the OTC pill. OTC access was also associated with a 41.0 percentage point increase in transitioning from use of a less-effective contraception method to use of the OTC pill.

“As reproductive health care access faces growing threats, OTC contraception offers a promising strategy to support reproductive autonomy and reduce disparities in contraceptive use. Improving community awareness of this option and insurance reimbursement policies will be essential to ensure equitable access and sustained impact,” the authors write.

One author disclosed ties to Perrigo.


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