JAMA Netw Open

Is OTC birth control closing gaps in care?

August 21, 2025

Removing OCP prescription requirements may be a powerful strategy to reduce disparities in contraceptive access and support reproductive autonomy, especially in regions with limited healthcare infrastructure. Clinicians should be aware of ongoing knowledge gaps and proactively educate patients about OTC options, safety, and effectiveness.

Study details: This cross-sectional study evaluated 986 individuals aged 15 to 45 across 49 U.S. states who obtained oral contraceptive pills (OCPs) between April 2024 and February 2025. Participants accessed either prescription or over-the-counter (OTC) progestin-only OCPs. The study aimed to assess whether OTC availability improved contraceptive initiation among populations facing structural barriers to care, including adolescents, uninsured individuals, and rural residents.

Results: OTC users were significantly more likely to be uninsured (31.6% vs. 3.5%) and live in rural areas (14.4% vs. 8.4%) compared with prescription users. OTC access was associated with a 31.8 percentage point increase (95% confidence interval [CI], 24.1-39.5 percentage points) in initiation among those previously using no contraception, and a 41.0-point increase (95% CI, 33.8-48.1 percentage points) among those switching from less-effective methods like condoms or emergency contraception.

Source:

Rodriguez MI, et al. (2025, August 18). JAMA Netw Open. Over-the-Counter Oral Contraceptive Use and Initiation of Contraception. https://pubmed.ncbi.nlm.nih.gov/40824637/