The FDA on Thursday approved Opill, the first over-the-counter daily birth control pill.
Five questions on coverage of the new birth control drug
The FDA’s decision to approve Opill, the country’s first over-the-counter birth control pill, was quickly cheered by reproductive-rights advocates who believe it will dramatically expand access to birth control.
But Thursday’s announcement also prompted several questions about how accessible the drug will be and whether the decision could become tied up in courts, delaying or limiting the decision’s effect.
Here are five questions in the wake of the FDA’s announcement.
Will Medicaid cover it?
Depends where you live.
A state Medicaid program shares the cost of covering prescription drugs with the federal government. There is some leeway for how Medicaid chooses to handle over-the-counter drug coverage.
The state can cover an over-the-counter drug, but the person must have a prescription to qualify for the federal matching funds.
Still, there are some ways states can get around this requirement to make it easier for people to get the drug.
For instance, a state can give pharmacists the power to prescribe the drug at the pharmacy counter. California enables pharmacists to prescribe prophylaxis, self-administered birth control and the overdose antidote naloxone among other products, according to a report from the legal advocacy group National Health Law Program.
Several prescribe similar contraceptives, which offers a clue as to which Medicaid programs might offer this new drug.
There are at least three state Medicaid programs that use a dummy provider identifier number, which is used to identify health care providers. A pharmacy in one of those states can submit the dummy number in place of a prescriber to get coverage for an emergency contraceptive such as the Plan B pill, according to the think tank KFF.
