Latest / CareTalk: Healthcare. Unfiltered. / The Arrival of OTC Birth Control

Transcript

The Arrival of OTC Birth Control · CareTalk: Healthcare. Unfiltered.

• 0:00
  Access to the birth control pill is becoming easier now that FDA has approved an over the counter version of a product that's been available on prescription since 1973.
• 0:10
  Nearly half of pregnancies are unplanned and abortion is getting much harder to access, so this approval is significant.
• 0:22
  Welcome to Care Talk, America's home for incisive debate about healthcare business and policy.
• 0:27
  I'm David Williams, president of Health Business Group.
• 0:30
  And I'm John Walgreens Health.
• 0:32
  Hey John, have you checked out the Care Talk newsletter recently?
• 0:35
  It's where you can read trending healthcare industry news, keep up with the latest podcast episodes and highlights, access original blog posts by healthcare thought leaders, and dive deeper into our podcast topics.
• 0:46
  Subscribe today and you'll be entered into a chance to win your very own Care Talk.
• 0:50
  Baseball cap.
• 0:51
  Although, John, you may be disqualified since you work here.
• 0:53
  Well, David, getting to the topic at hand, what's all the excitement about birth control?
• 0:59
  Isn't this just sort of more of the same?
• 1:01
  What exactly did the FDA approve?
• 1:03
  John, it is very exciting.
• 1:04
  It's not more of the same.
• 1:05
  Uh, they approved Opil.
• 1:07
  That is a progestin only once daily birth control pill.
• 1:10
  The product has been around for about 50 years.
• 1:13
  Now they sometimes call this the mini pill because it contained, it does not contain estrogen.
• 1:18
  What that means is that, uh, there's almost no risk of blood clotting, which is sometimes a concern with birth control pills.
• 1:23
  It's still very effective, something like 93%, but it doesn't start working quite as fast and it's a lot more sensitive to be taken every, has to be taken every time, every day at around the same time.
• 1:34
  Uh, but yeah, it's a big deal, John.
• 1:35
  It's going to be available over the counter, no age restriction.
• 1:38
  So it's going to increase availability a lot.
• 1:42
  I think this is really important.
• 1:43
  You know, there's a, a clear majority of American women, you know, recent studies, you know, 18 to 50, well over 60% of women support over the counter.
• 1:57
  Distribution of drugs.
• 1:59
  You know, people in health care generally misunderstand or people in the health care system generally under misunderstand how dangerous barriers to health care are and how inconvenient health care is, you know, of the 6.
• 2:13
  1 million pregnancies in America, half of them are unplanned.
• 2:17
  This is a very important issue for women and families across the country and to safely to identify safe providers.
• 2:27
  Uh, choices and alternatives and contraception, I think is a, is a really good thing.
• 2:31
  Are there anything that, are there any things that people should be worried about as it birth control pills move from prescribed by a doctor and managed by a doctor to dispensed over the counter with the support and counsel of a pharmacist?
• 2:42
  Well, John, you know, that our shows, the most popular ones are ones where we're disagreeing with one another and, and that's not that hard to do, but I will point out on this one, actually both, uh, AOC and Ted Cruz.
• 2:53
  I agree that there should be over the counter birth control, but let's talk about the arguments because it wasn't actually a complete slam dunk for this to be approved by FDA.
• 3:03
  So the main argument is probably that it should be supervised by a physician or other health care practitioner.
• 3:09
  So that's the argument.
• 3:10
  Hey, these have been prescribed a long time.
• 3:12
  Now it isn't.
• 3:13
  Now in practice, however, what happens is physicians.
• 3:15
  And others prescribe birth control pills, but that's not like they're really monitoring it.
• 3:19
  So there's not that much of a difference.
• 3:21
  Um, there's also some people that are not eligible for this, uh, for this pill.
• 3:26
  And those tend to be people who have breast cancer, had breast cancer.
• 3:30
  Or sometimes high blood pressure, there could be other reasons, some, uh, uh, history of bleeding.
• 3:35
  Um, and there have been some studies that showed that about 7% of women incorrectly think they may be eligible based on their self assessment.
• 3:42
  The thing is, that's not really any different, uh, from what happens if they're supervised by a healthcare.
• 3:47
  provider.
• 3:48
  There's a couple of other arguments to John, but I'll let you go on with your point.
• 3:50
  No, but in pharmacists can actually play that role of counselor.
• 3:54
  I mean, I do think that anytime you're ingesting a drug into your body and affecting the complex biochemistry of your unique body, you should be getting the counsel of a healthcare professional.
• 4:06
  But, you know, David, this, and, and, and any drug going into your body is going to change the.
• 4:11
  The biochemistry, heck, that's the reason why it's there in the first place is to prevent conception.
• 4:18
  Uh, the U.
• 4:19
  S.
• 4:20
  is a real laggard here.
• 4:21
  I mean, uh, birth control pills are available over the counter with the counsel, uh, and support of a pharmacist in over a hundred countries.
• 4:31
  This is a, to your point, an old technology, and old technology is, when we were saying it's measured and stable and we've seen the results, there's definitely You know, things to be careful about.
• 4:42
  Uh, if you're a breast cancer survivor, as my wife is, you, you, you want to be under the, um, counsel, uh, of a, of a doc, but in terms of the specific things one needs to know about it, it would strike me that we are, Uh, not, not just right, but probably late as a country in approving this drug.
• 5:03
  So, John, uh, there is this movement, I think they call it free the pill, that makes this point about over a hundred countries, uh, that, uh, have OTC birth control pill.
• 5:12
  Now, what you mentioned there about, uh, pharmacists, uh, I would agree with.
• 5:15
  However, just to be clear, This approval does not require a pharmacist to be involved.
• 5:20
  Uh, it allows, uh, somebody of any age to go and purchase the product, wherever it may be sold.
• 5:24
  And that may be in a pharmacy, John, which I hope for your benefit it is, but it could also be in a, in a grocery store, a convenience store, um, anywhere.
• 5:33
  And so what this really does is promote access to a large degree.
• 5:37
  So there are a lot of people that have a barrier.
• 5:39
  Some studies have shown up to like a third of adult women have barriers to accessing birth control on prescription basis.
• 5:46
  And that's because either they don't have insurance, it's hard to get an appointment at a clinic, the clinic wants to do tests and so on.
• 5:52
  But even there that one of the places this is going to make the biggest difference is for some of the youngest.
• 5:57
  Women, uh, who actually tend to face a lot of barriers and they don't have such a barrier to go to the store and, and grab something, um, off the shelf.
• 6:06
  You're on a really big issue because I think, again, the, the typical healthcare industry doesn't really realize how hard it is for people to access care and how, how, sort of continuously inconvenient it is to go for a test or go for a meeting or set up a meeting and make it given how busy people are, we're often working one or two jobs having to take care of children or in this case hoping not to take care of children.
• 6:34
  The, the, the, there are major dislocations of terms of access to care and when you come, when you can lower those barriers and allow access Uh, inexpensive access in more places, I think we're going to have a healthier society.
• 6:52
  I think that the inaccessibility and just hassle factor is probably resulting in a lot of women not getting the health care that they need.
• 7:01
  So John, when they talk about, um, you know, where's their common ground, say an abortion, um, you know, one of the things is that many people agree it should be rare, very rare, if not happening at all.
• 7:13
  And contraception is one of the ways.
• 7:15
  You know, that that can happen.
• 7:17
  It's interesting to note, I hadn't realized this until we were doing some research for this episode, John, but, uh, most states actually cover contraception in Medicaid.
• 7:27
  So 32 states cover condoms, actually, as a reimbursed expense for, for Medicaid.
• 7:32
  And there really isn't a lot of organized, um, opposition to contraception.
• 7:36
  I know we've often talked about in the wake of the Dobbs decision about, well, is contraception next?
• 7:41
  And there is actually a surprising amount of.
• 7:44
  Uh, consensus that should be available, and this is making it more available.
• 7:48
  There's public consensus.
• 7:50
  There certainly has been, particularly in some of the, uh, the interpretations of what Judge Thomas has written, um, some lines that would suggest, uh, I think it's in the Griswold decision that he's questioning the basis.
• 8:05
  Of even, um, whether the, the, the decision to make access to contraception available to most people is, was a, it was an accurate, um, and, and, and legally, um, fair or, uh, well thought through judgment.
• 8:22
  So I, I wouldn't dismiss.
• 8:25
  The concerns about the right wing because they've raised it in, in, in, in the Dobbs decision and others question about legal precedence around contraception, but there is widespread political support for contraception.
• 8:39
  And it's, it's encouraging that your buddies, AOC and Ted Cruz, uh, who in many ways describe the, the, the extreme ends of the political spectrum are, are, are hopping on the bandwagon to support.
• 8:54
  This access to this, uh, to the strike.
• 8:57
  I just think it's a win for women's health, and I think we should celebrate it is that and hopefully People will use this and look at this as a reason to kind of revisit all the barriers to women's health that not just around contraception, but around access to, um, all kinds of, uh, uh, care relating to prenatal care and childbirth, but also care for women in at all stages of life, which, which if you look at it statistically, they're, they're not getting the care they need.
• 9:26
  John, next time I have Justice Thomas or any of the other justices on my private jet, I will make sure to, uh, reiterate my support here and also, uh, see if they've had any, have any opinions about the male birth control pill.
• 9:37
  But until then, John, I think we should wrap it up and say, that's it for yet another episode of Care Talk.
• 9:42
  We've been talking today about the approval of an OTC product.
• 9:46
  for birth control.
• 9:48
  I'm David Williams, president of Health Business Group.
• 9:50
  And I'm John Driscoll, the president of Walgreens Health.
• 9:53
  If you like what you heard or you didn't, we'd love it if you'd subscribe on your favorite service.