Boxes of Opill are shown in this undated image provided by Perrigo Company. Opill is the first over-the-counter birth control pill available in the United States, has an estrogen-free formulation and currently has no age restrictions.
Courtesy of Perrigo Company
Opill, the first birth control pill available without a prescription, arrived on the shelves in Oregon this week.
CVS, Walgreens, and Rite-Aid are among the major retailers selling it in stores and online.
OPB confirmed that it is available statewide with spot checks in the Portland area and phone calls to pharmacies in Bend, Eugene and Ontario. It costs about $20 for a 28-day supply.
Opill is a progestin-only pill, with far fewer risks than familiar combination birth control pills that contain both estrogen and progestin. The FDA approved it for over-the-counter use last year.
It can be safely taken by virtually anyone, including many people who are not supposed to take combination pills, such as nursing mothers, people with high blood pressure, and people with vascular disease.
Related: FDA approves Opill, the first daily birth control pill without a prescription
The FDA’s review found that people could successfully read the label and self-screen for the medication. And there’s no medical test, like a pelvic exam, required to take it.
“It’s an incredibly safe method, and we’re really lucky to be at this time and place that we have this available to us,” said Alison Edelman, a professor and obstetrician-gynecologist at Oregon Health & Science University. Edelman and OHSU received funding from HRA Pharma, the company that developed Opill, to research the impact of missed doses on ovulation, as part of the FDA approval process.
Women’s health experts hope the over-the-counter option will make it easier for people to get birth control and reduce unintended pregnancies, particularly for young people and anyone who struggles to see a health provider regularly.
Edelman said it’s also common for women who have a preferred method of birth control to let that prescription lapse and run out of pills. With health care services under strain, it can be hard to quickly schedule an appointment with a primary care doctor.
People in that situation can use the Opill as an “in between” method for a month or two, while they’re waiting to get a new prescription.
“It’s just an added choice, and I think we all benefit,” Edelman said.
Opill is less time sensitive than previous progestin-only pills
When used “perfectly,” according to the label instructions, Opill is 99 percent effective, meaning one person out of 100 will become pregnant over the course of a year on the pill. When used under real-world conditions (in which a person misses a dose every once and a while), it’s 93 percent effective, comparable to combination pills.
One challenge associated with progestin-only pills like Opill is that to be effective, they need to be taken at roughly the same time every day. The pill’s FDA label says people should use a back-up method of contraception, like condoms, if the Opill is taken 3 or more hours late.
Edelman said the Opill is less time sensitive than previous progestin-only pills. It uses a different form of progestin in a larger dose.
The FDA, however, stuck with the 3-hour warning on the label “to be super safe,” Edelman said. “The study didn’t show any increased risk of ovulation.”
Other women’s health experts said the most important thing is to tie the habit of taking the pill to another part of your daily routine, like brushing your teeth or eating breakfast.
“As human beings, we’re notoriously poor pill takers, whether it’s for a heart condition or for contraception,” said Cynthia Harper, a professor of obstetrics and gynecology at the University of California, San Francisco.
Related: In Washington state, pharmacists are poised to start prescribing abortion drugs
Harper agreed that the label is conservative and people shouldn’t stress too much if they’re late occasionally.
“We do have a lot of evidence that shows now that, if you take this pill 6 hours late, it’s still going to be highly effective,” Harper said.
Oregon has a wide range of birth control options that people can get without needing to make an appointment with a doctor first.
A 2016 law allowed trained pharmacists to prescribe short-acting methods including combination pills, the patch and the ring. They can bill patients’ insurance, including Oregon Health Plan, the state’s Medicaid program for low-income people.
Pharmacies with staff trained in the program will generally post signs or stickers indicating they can prescribe birth control on site.