October 2011, Washington, DC: Comprehensive status update on the advancement of OCs OTC and the maintenance of insurance coverage for an OTC option
In October 2011 the working group held two meetings in Washington, DC. The first day was a general working group meeting, and the second was a meeting with a smaller group of advocates to discuss possible mechanisms for public and private insurance coverage of OCs in an OTC environment.
Forty-five people participated in the general working group meeting, including clinicians, pharmacists, health researchers, advocates, and representatives of several pharmaceutical companies. The focus of this meeting was to provide an overview of the latest evidence on the safety of OTC use of OCs and women’s and providers’ perspectives on OTC access; review the working group’s decision to move forward with a progestin-only pill (POP) as the first OTC OC; discuss cost and insurance coverage in an OTC environment; and identify strategies for pursuing an OTC switch for a POP product.
The following day 25 representatives from reproductive rights, health, and justice organizations met to discuss strategies for ensuring Medicaid coverage of OCs in an OTC environment and to explore opportunities for getting private insurance coverage of OTC contraceptives in the wake of health reform. At previous meetings, advocates had identified Medicaid coverage of OTC contraceptives without a prescription as a working group priority to ensure that all women would reap the benefits of an OTC switch. Coverage of OTC drugs, including OTC contraceptives, is optional under Medicaid, but when states do cover them, a prescription is required for federal reimbursement.