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Advisers to the FDA back over-the-counter birth control pill

An advisory panel to the Food and Drug Administration supported drugmaker Perrigo's application to sell the oral contraceptive Opill without a prescription.
Perrigo
An advisory panel to the Food and Drug Administration supported drugmaker Perrigo's application to sell the oral contraceptive Opill without a prescription.

Updated May 10, 2023 at 5:07 PM ET

In a unanimous vote, 17-0, a panel of advisers to the Food and Drug Administration recommended that the agency approve the first over-the-counter birth control pill.

If approved, the pill would be sold by Perrigo under the brand name Opill. It is a so-called progestin-only pill that contains only a synthetic version of the hormone progesterone to prevent pregnancy. Most pills also contain estrogen. While the FDA typically follows the recommendation of its advisory committees, it isn’t required to.

In comments after the vote, panel members explained their support for the prescription-free pill.

“I feel that the risk of unintended pregnancy is lower with this approach than any of the other available contraceptive approaches that women have access to without seeing a health care provider,” said Dr. Deborah Armstrong, a professor of oncology, gynecology and obstetrics at Johns Hopkins. She added that she thought people would be able to understood if any health conditions they have would be incompatible with taking the pill.

“I voted yes because the evidence demonstrates that the benefits clearly exceed the risks,” said Kathryn Curtis, a health scientist with the Centers for Disease Control and Prevention’s division of reproductive health. The benefits include increased access to effective birth control, reduction in unintended pregnancies and its risks and increased reproductive autonomy. “Opill has the potential to have a huge public health impact,” she said.

The recommendation, which came at the conclusion of a two-day public meeting, was welcomed by major medical groups.

“More than 60 years of safe and effective use of oral contraceptives have shown that the benefits of widespread, nonprescription availability far outweigh the limited risk associated with their us — with evidence showing that pregnancy poses much greater health risks,” said Dr. Jack Resneck Jr., the president of the American Medical Association, in a statement.

“At this tumultuous time for reproductive health in the United States, allowing access to OTC oral contraceptives is a safe and necessary step that must be taken to ensure that all individuals are able to effectively limit unintended pregnancies, particularly those with limited access to health care options,” Resneck said.

FDA scientists had questioned whether the company had provided convincing evidence that women could safely and effectively take the pill without the guidance of a health professional. Specifically, the agency researchers raised concerns that women may not take the pill at about the same time every day, which is necessary to prevent pregnancy. They also expressed concern that women who have breast cancer would fail to realize it would be dangerous for them to take the pill.

But the advisers concluded that there was a sufficient evidence to conclude that women knew enough about how to use oral contraceptives safely and effectively. Committee member also questioned how much guidance women typically get from a medical professional prescribing the contraceptive pills.

“I think this represents a landmark in our history of women’s health. Unwanted pregnancies can really derail a woman’s life, and especially an adolescent’s life,” said Dr. Margery Gass of the University of Cincinnati College of Medicine, another committee member. “So I’m very pleased that the FDA is seriously considering this. And I look forward to it being on the market.”

Copyright 2023 NPR. To see more, visit https://www.npr.org. utm

Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.

Hensley has worked on award-winning investigations in collaboration with journalistic partners.

He was the lead NPR editor on an investigation with the Center for Public Integrity in 2018 that exposed drug industry influence on the choices of preferred medicines by Medicaid programs. The work won the 2019 Gerald Loeb Award for audio reporting.

In 2017, Hensley was the lead NPR editor on an investigation with Kaiser Health News that showed how the pharmaceutical industry exploits government incentives intended to encourage the development of treatments for rare diseases. The stories won the 2019 digital award from the National Institute for Health Care Management.

Hensley has been editing in his current role since 2019. He joined NPR in 2009 to launch Shots, a blog that expanded to become a digital destination for NPR health coverage.

Before NPR, Hensley was a reporter and editor at The Wall Street Journal. He was the founding editor of The Wall Street Journal Health Blog, which focused on the intersection of health and business. As a reporter, he covered the drug industry and the Human Genome Project.

Hensley served on the board of the Association of Health Care Journalists from 2012 to 2020.

He has a bachelor's degree in natural sciences from Johns Hopkins University and a master's in journalism from Columbia University.

Before becoming a journalist, Hensley worked in the medical device industry. He remains, now and forever, a lover of Dobermans, lacrosse and Callinectes sapidus.

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