A health-care company founded last fall is looking to increase the number of women using emergency contraception (EC) in one simple way: by cutting its price in half.
The U.S. Food and Drug Administration in June 2013 approved the sale of Plan B One-Step, a brand-name variety of EC, over the counter to people of all ages. The FDA also announced that manufacturers of generic versions of Plan B One-Step could apply for over-the-counter sale.
The move was heralded as a success for contraception access, since women previously had to get their doctors to write a prescription for Plan B.
But over-the-counter access came with a price: On average, stores like CVS sell one pill, or one dose of Plan B, for $48, according to the American Society for Emergency Contraception. Generic versions aren’t much cheaper, averaging just over $41 at the same stores.
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AfterPill, which is sold only online and is also a generic version of Plan B, offers one dose of EC for $20, plus a $5 flat-rate shipping fee.
Jamie Barickman, managing director of Syzygy, which started selling AfterPill in July, told Rewire in a phone interview that Syzygy was able to reduce the price by selling AfterPill only online. “Forty or 50 dollars at retail is very high,” he said. “So we try to reduce the price at retail by marketing it directly to the consumer.”
An average heterosexual American woman spends the vast majority of her reproductive life trying not to get pregnant. A woman who wants two children, for example, will spend about five years trying to become pregnant, pregnant, or postpartum, and three decades avoiding pregnancy, according to the Guttmacher Institute.
At the same time, more than 50 percent of Americans say they have had unprotected sex with a new partner at least once, and half of pregnancies are unintended.
Enter the morning-after pill. Billed as a last-ditch effort to prevent pregnancy, most people report using EC either because they used no contraception while having sex or they think the method they used didn’t work.
Even though EC is both safe and effective, it’s was not widely used until more recently—only 11 percent of women reported ever using emergency contraception between 2006 and 2011, for example—in large part due to lack of access to and widespread misinformation about the method, as well as age limitations on its purchase.
The AfterPill website bills itself as a discreet alternative to buying EC at the store, where interacting with a cashier is inevitable.
“AfterPill™ is personal and private,” the website reads. “No embarrassing questions. No disapproving looks.”
AfterPill is packaged in unmarked boxes with no brand logo or description displayed on the outside.
Being able to purchase the pill online also removes other barriers to access, according to Kelly Cleland, a research specialist in the office of population research at Princeton University. For one, “stores are not consistently stocking emergency contraception on shelves, and people still have to go ask the pharmacist.” While some people feel comfortable approaching the pharmacist for EC, others don’t, and will instead leave empty handed.
Even though Plan B and its generics can now legally be sold over the counter to people younger than 17, pharmacists and cashiers still incorrectly turn people away. For instance, a recent study found that 20 percent of men trying to by EC are incorrectly denied.
“I think it’s a great thing for people to have all sorts of different options and for many women,” says Cleland, who also runs Princeton’s emergency contraception website. “People should have access to whatever method works for their lifestyle.”
There are some downsides to the new pill. For example, AfterPill cannot process any insurance, which means that women who get EC prescriptions from their doctors can’t use them to buy AfterPill, so their insurance will not cover the cost.
And, of course, there’s the problem of timing. The AfterPill website says it will arrive up to a week after purchase, which raises questions about its utility in an emergency and sets it apart from other ECs that can be bought at a local store after unprotected sex.
Barickman, for his part, acknowledges that AfterPill can’t be used in the way conventional ECs are used.
But, he said, because AfterPill is relatively cheap, it can actually encourage women to plan for contraception emergencies. Planning ahead for unprotected sex is like buying a fire extinguisher in case of a fire, and the cheaper EC is, said Barickman, the more likely women will order it in advance.
The sooner you take emergency contraceptives after having unprotected sex, the more likely it is to work, so “there’s an efficacy benefit of having the product on hand.”