Why Women Struggle to Find Low-Cost Emergency Contraception

Scott Olson/Getty Images

Scott Olson/Getty Images

In a perfect world, contraception would be free to everyone. Alas, health care costs are a growing concern for many Americans, especially women. While prices should not be a barrier to obtaining safe and reliable health care to prevent pregnancy, this is the reality for some women. The good news is there are a number of options available to women seeking affordable emergency contraception.

Commonly referred to as the “morning-after pill,” oral emergency contraception is available over the counter to women and men of all ages. While you could still see a disclaimer on generic medications saying it is intended for use by women ages 17 and older, anyone can buy it without showing ID.

Here’s why you might see those age disclaimers.

In 2013, Teva, the manufacturer of Plan B, was granted a three-year exclusivity agreement allowing its product to be the only emergency contraceptive sold over the counter without age restrictions. When the FDA finally reversed this agreement, allowing generics to be sold over the counter, the department also required these generics to include the label “for ages 17 and up.” To compensate for reversing its earlier agreement with TEVA, Plan B would be the only emergency contraceptive pill without an age restriction label.

Of course, this label is meaningless, since no one is required to show proof of age. It appears that this labeling decision, which has nothing to do with patient safety, only served to pad Teva’s bottom line. These labels not only confuse patients, they lead pharmacists to spread false assertions. A 2013 study found 20% of pharmacy staff told callers that teens could not access emergency contraceptives. Only about half of the remaining respondents gave completely correct information.

Today, it’s up to consumers to navigate misinformation and barriers to access.

Whether you choose an oral method or an IUD, you can also receive emergency contraception at a Planned Parenthood health center or family planning clinic. Since emergency contraception is time sensitive, Planned Parenthood recommends getting it ahead of time:

“Since emergency contraception works better the sooner you take it, it’s a good idea to get emergency contraception before you need it just in case. That way you’ll have it on hand if an accident happens, and you won’t have to worry about running out to a drugstore or waiting to get an appointment for a prescription.”

The three major methods of emergency contraception are ParaGard IUD insertion, Ella, and Plan B One-Step or similar oral medications. Generally, costs vary from $30 to $65 for the morning-after pill and $500 to $900 for IUD insertion. For women interested in how each option works, Planned Parenthood has outlined the choices below.

Source: Planned Parenthood

Source: Planned Parenthood

ParaGard

While the ParaGard IUD is expensive up front, ranging from $500 to $900, it’s an economical choice in the long run because it can be left in as an effective birth control for years. Mirena, the other type of IUD, cannot be used as emergency contraception, but ParaGard can be used for this purpose when inserted up to five days after unprotected sex. It may not be as convenient as picking up emergency contraception at a pharmacy, but ParaGard is 99.9% effective.

Ella

Ella is sold by prescription only to women of all ages. It can be picked up at a pharmacy or ordered online via a prescription service for $59, which includes next-day delivery. Ella contains ulipristal acetate, a progesterone receptor modulator, and it is effective for up to five days after unprotected sex.

Plan B, AfterPill, and others

Some of the more common emergency contraceptive pills include Plan B One-Step, Next Choice One Dose, My Way, and Take Action, and prices typically range from $35 to $60. The active ingredient in these medications is levonorgestrel, a synthetic progesterone. A generic form of Plan B One-Step, called AfterPill, is available for only $20 (plus $5 shipping) at afterpill.com. The website does not offer expedited shipping, so it’s not meant for emergency use, but it’s likely the cheapest option available if you want to have it on hand for the future. These pills are most effective up to three days after unprotected sex.

The Yuzpe method

There is one more emergency contraception method, and it goes back to the 1970s. Named for Professor A. Albert Yuzpe who conducted studies in 1974, the Yuzpe method involves using everyday birth control pills as emergency contraception. Only certain types of traditional birth control pills can be used in this way. The approved brands and dosage information can be found at The Emergency Contraception Website. This method is most effective when used within 72 hours after having unprotected sex.

For comprehensive information on emergency contraception costs and payment assistance, visit bedsider.org.

Does health insurance cover emergency contraception?

If you have health insurance, you may be able to obtain emergency contraception at no cost, including IUDs and over-the-counter medications. The Affordable Care Act requires insurers to fully cover contraceptive costs, though there are some exceptions. Because of the Supreme Court’s ruling in favor of Hobby Lobby, religious employers can get out of providing contraceptive coverage, though it’s possible employee costs will still be covered by the insurance company in accordance with the ACA. Depending on the plan, insurers also may require a prescription before providing coverage, even for over-the-counter emergency contraceptives. Finally, as with traditional birth control pills, certain name-brand emergency contraceptives will likely be exempt, but generics should be completely covered in accordance with federal law.

Even if you don’t have health insurance or you are in a grandfathered plan that doesn’t cover emergency contraception, you may be eligible for cost savings through a family planning waiver or by contacting your local health department.

Prices still need to come down

Although over-the-counter availability is a positive step, according to a July 2013 study by the American Society for Emergency Contraception, prices can still be a significant obstacle to women receiving the contraceptive care they need. The study concludes:

“While moving the product from pharmacy to shelf is a tremendous step forward, price continues to be a barrier. The introduction of generics has not dramatically lowered the price of EC; while generic drugs typically cost 80-85% less than their branded counterparts, this differential is only 14% for EC products. Therefore, even the lowest price in retail outlets is out of reach of many women. To make EC truly accessible for all who need it, prices must be lowered to a more affordable level.”

More information

For more information on emergency contraception consult with Planned Parenthood or The Emergency Contraception Website.

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