After nine years of research, Opill became the first ever over-the-counter birth control pill available this past March for patients to purchase on Amazon, Opill.com (operated by Perigo), CVS, and other retailers. 1 It requires no prescription before purchase and is expected to be easily bought from local retailers. Having gained its approval from the FDA in 2023 and now being on the market, Opill intends to expand access to safe and effective contraception for those who may find it difficult or impossible to visit a healthcare provider for a prescription. 2

Opill alleviates barriers to obtaining birth control, as nearly one-third of oral contraceptive users miss their birth control due to the inability to obtain their prescription on time. 4 5 It is also projected to improve outcomes of unintended pregnancies. Nearly six million pregnancies in the US annually are unintended, leading to poor perinatal and maternal outcomes; Opill could act to reduce these numbers. This over-the-counter birth control pill is seen as a game-changer that allows birth control and reproductive health to be on people’s terms. 3

Opill is a progestin-only pill (POP), having a contraceptive efficacy similar to that of norgestrel, which was originally established for prescription usage in 1973. 1 2 A one-month supply of Opill retails for $19.99, and a three-month supply is estimated to be $49.99. For those unable to afford Opill or who do not have insurance, Perrigo offers a patient assistance program. The pill should be taken at the same time every day, as full adherence to the pill is important for the effectiveness of Opill, much like many other contraceptive pills.

Opill is projected to have 98% effectiveness in preventing pregnancy, provided the patient adheres to the instructions, and should be effective 48 hours after taking the first directed dose. It cannot be used as an emergency contraceptive, abortion medication, or STI prevention method. Some side effects may include headaches, bloating, and cramping.

Although Opill is seen to be revolutionary as it launched as the first OTC birth control pill, some issues have emerged due to its coverage and affordability. Research done by KFF explores insurance coverage and the statistics of women who would pay the out-of-pocket cost of OTC birth control. Of the women surveyed, only a third would be willing to pay the $19.99 monthly fee. Nearly 40% of women would be more likely to pay for OTC birth control if it were priced from $1.00 to $10.00. 5

However, several states have come to rectify this issue by requiring state regulations for private health insurance plans to cover some of the over-the-counter contraception costs without a prescription. States such as New York, Maryland, New Jersey, Washington, and California require private insurance and Medicaid to cover part of the cost, while other states like Colorado and New Mexico require private insurance only. Michigan and Illinois require that only Medicaid buffer the cost of Opill.