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A company is seeking FDA approval for the 1st nonprescription birth control

AILSA CHANG, HOST:

A Paris-based drug company is seeking approval from the U.S. Food and Drug Administration for an over-the-counter birth control pill. If approved, it would be the first oral contraceptive available in the U.S. without a prescription. For more details on this, we’re joined now by NPR’s Allison Aubrey. Hey, Allison.

ALLISON AUBREY, BYLINE: Hey, Ailsa. Good to be here.

CHANG: Good to have you. OK, so, I mean, birth control pills have been on the market for – what? – 60 years now? They’ve always required a prescription. Just tell us why that might change now.

AUBREY: You know, the argument in favor of over-the-counter birth control is that it would help reduce barriers to contraception access. Survey research has shown that as many as 30% of women of childbearing age report a problem obtaining a birth control prescription or getting refills. The reasons people give vary. Some report not having a regular doctor, challenges getting an appointment or just being hesitant to go. I spoke to Dr. Jenny Villavicencio at the American College of Obstetricians and Gynecologists, who says logistics can be an obstacle, too.

JENNY VILLAVICENCIO: Taking time off work, getting child care, driving, parking, all of those things, then going to the pharmacy to pick up your prescription. It also incurs financial costs, particularly if you are under-insured or uninsured. And so those are just some of the barriers that exist with contraception, which we know is safe. And the science and the data has for a while shown that birth control is very safe to be offered over-the-counter and doesn’t need a prescription.

AUBREY: Her group includes about 60,000 obstetrician-gynecologists. They’ve been on the record in support of over-the-counter birth control going back to 2012. And now, given the uncertainty over reproductive rights after the overturning of Roe, there’s a heightened sense of urgency, Ailsa, to address these barriers, because reliable contraception is so important.

CHANG: So much more important these days. OK, so, I mean, how new of an idea is this, though, to make the pill available in the U.S. without a prescription?

AUBREY: Not really new. I mean, this has been in the works for years. A coalition called Free the Pill, which includes advocates, researchers, health care providers, has really been building the case going back to 2004. They have helped to lay the groundwork and kind of build the evidence base to support an FDA application. I spoke to the group’s project director, Victoria Nichols, who explains the company that has submitted the application, HRA Pharma, must meet a whole bunch of FDA criteria to get over-the-counter approval.

VICTORIA NICHOLS: A person has to be able to take the medications as intended without a doctor’s explanation. That’s something that the pharmaceutical company has to prove through their data and their research. We believe that these pills are safe and effective and that people should be able to follow the simple instructions. You take a birth control pill once every day.

AUBREY: Dozens of countries around the globe have over-the-counter birth control, Ailsa, including Mexico, a bunch of Latin American and European countries. Last year, HRA Pharma, the company seeking FDA approval, got a license to bring a non-prescription contraceptive pill to the U.K., too.

CHANG: So what do you think the timing on this will be? Like, when would the FDA decide whether to approve this over-the-counter birth control pill?

AUBREY: Well, people watching this closely estimate the process could take about 10 months. The agency could ask a group of advisers to review the evidence, so sometime in 2023. You know, strategically, the company is seeking approval for what’s called a minipill, which does not contain estrogen. And this makes it lower risk, since estrogen in the pill is linked to blood clot risks, which has always been something that doctors screen for when they prescribe the pill. So this progestin-only pill can be slightly less effective – 91% with typical use. But since it does not carry the same risks, doctors tell me it makes sense as a potential first over-the-counter option here.

CHANG: So exciting. That is NPR’s Allison Aubrey. Thank you, Allison.

AUBREY: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Allison Aubrey is a Washington-based correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She has reported extensively on the coronavirus pandemic since it began, providing near-daily coverage of new developments and effects. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.

Along with her NPR science desk colleagues, Aubrey is the winner of a 2019 Gracie Award. She is the recipient of a 2018 James Beard broadcast award for her coverage of 'Food As Medicine.' Aubrey is also a 2016 winner of a James Beard Award in the category of "Best TV Segment" for a PBS/NPR collaboration. The series of stories included an investigation of the link between pesticides and the decline of bees and other pollinators, and a two-part series on food waste. In 2013, Aubrey won a Gracie Award with her colleagues on The Salt, NPR's food vertical. They also won a 2012 James Beard Award for best food blog. In 2009, Aubrey was awarded the American Society for Nutrition's Media Award for her reporting on food and nutrition. She was honored with the 2006 National Press Club Award for Consumer Journalism in radio and earned a 2005 Medical Evidence Fellowship by the Massachusetts Institute of Technology and the Knight Foundation. In 2009-2010, she was a Kaiser Media Fellow.

Joining NPR in 2003 as a general assignment reporter, Aubrey spent five years covering environmental policy, as well as contributing to coverage of Washington, D.C., for NPR's National Desk. She also hosted NPR's Tiny Desk Kitchen video series.

Before coming to NPR, Aubrey was a reporter for the PBS NewsHour and a producer for C-SPAN's Presidential election coverage.

Aubrey received her Bachelor of Arts degree from Denison University in Granville, Ohio, and a Master of Arts degree from Georgetown University in Washington, D.C.

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