Today's Perspective
Kristin Wiisanen PharmD, FAPhA, FCCP, Pharmacy Today editor in chief
It can be a double-edged sword when a previously prescription-only medicine becomes available over the counter. Although an Rx-to-OTC switch can save patients time, increase access, and potentially decrease costs, there are also cases when Rx-to-OTC switches actually make it harder for patients to get medications. For example, with some PPIS, many insurers stopped covering prescription forms since they became available without a prescription...but the price of the OTC version ended up being higher than the patient’s previous copay for the prescription form.
This month’s Pharmacy Today cover story explores these and other challenges unfolding now with Opill, a progestin-only birth control pill approved as over the counter by FDA in July 2023. Cost is a concern, with some pharmacies not carrying Opill because they aren’t able to match online prices. At the state level, most discussions on insurance coverage of Opill are still in the early stages.
Insurance coverage is a huge need for patients. According to Sally Rafie, PharmD, and founder of The Birth Control Pharmacist, “No one should be denied access to birth control pills over the counter due to cost barriers.” Learn more about state- and federal-level payment initiatives for Opill in this issue.
You’ll also get the latest on newly approved drugs including Rezdiffra, the first treatment for adults with liver scarring due to fatty liver disease; and the rise of overdose deaths from nitazenes, powerful illicit synthetic opioids. You can learn more about shilajit for boosting vitality, the mortality benefits of treating ADHD, and catch up on your CPE credit with this month’s article on human trafficking.
When your patients do purchase Opill, keep in mind important counseling points, since progestin-only birth control pills require more diligence than combination oral contraceptives. Most importantly, it is crucial that the patient take the pill at the same time every day within a 3-hour window. Not following this schedule can lead to changes in hormone levels, reduce efficacy, and increase the risk of unintended pregnancy, leading some pharmacists to refer to progestin-only pills as “baby-maybe” pills if not taken regularly. Patients should also be on the lookout for irregular bleeding and contact their doctor if it is unusually heavy or lasts longer than 8 days. Get a patient-friendly list of other key counseling points in the article.
Have a great Today! ■