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Drug manufacturers are unlikely to make the Pill OTC, so improved access has to be accomplished through other means.

Drug makers to date have little interest in going through the process to make a drug over-the-counter because it can take a long time and the costs are significant. Only the drug manufacturer can initiate this process with the FDA, which decides on the prescription or OTC status of a drug based on applications submitted voluntarily by the manufacturers. Lawmakers cannot change the status of a drug from prescription to OTC. Further, any decision involving birth control can be politically controversial. [30] [65]

Instead, some states are making birth control available without a prescription, but not over-the-counter. In those states, a pharmacist is required to ask the patient a few questions, notes blood pressure and weight, and dispenses birth control from behind the pharmacy counter. Many states including California, Maryland, Tennessee, and Washington allow birth control without a prescription. California, Maryland, and DC even allow 12-month supplies to be dispensed at once, which has been found to reduce unintended pregnancies by 30% and the odds of an abortion by 46%. The birth control in these cases is covered by insurance. A study found that 68% of women would use birth control if it were available via a pharmacist and 63% agreed the pharmacist consultation was an important step. [66] [67] [68] [127]

Women in some states can access birth control via an app or website from private companies. Insurance covers some of these prescriptions, and all that is generally required is a brief consultation to assess risks and appropriate medication, sometimes by video chat. Some services deliver the birth control to the patient, eliminating the need to stop by a pharmacy. [69] [70] [71] [72]

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