Meetings


September 2016, Washington, DC: Annual working group meeting
Our annual OCs OTC Working Group meeting took place on September 20, 2016 in Washington, DC and approximately 90 participants were in attendance. Topics covered during the meeting included reproductive justice perspectives on OCs OTC, developments on contraceptive access for young people, an overview of a national survey on women’s interest in using an OTC progestin-only pill, updates on policy developments, and a presentation on key messages about OCs OTC. Additionally, we had the kick-off meeting for our four new working group subcommittees, led by their cochairs. You can find the meeting agenda here.
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June 2016, Washington, DC: Making Access a Reality for All: Reproductive Justice Perspectives on Moving Oral Contraceptives over the Counter
We convened a meeting of 30 Reproductive Justice (RJ) advocates on June 7, 2016 in Washington, DC, to discuss RJ perspectives on moving OCs OTC.
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October 2015, Washington, DC: Annual working group meeting
Our annual OCs OTC working group meeting took place on October 20, 2015 in Washington, DC, and 70 participants were in attendance. Topics covered during the meeting included an update on where we are and the developments over the past year, a recap from a meeting held with reproductive justice advocates in May, cost and insurance coverage of a future OTC OC, politics and OCs OTC, adolescent OTC OC access, communicating key messages about OCs OTC, other strategies to improve access to hormonal contraception, and next steps. You can find the meeting agenda here.
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May 2015, Washington, DC: Making Access a Reality for All: Reproductive Justice Perspectives on Moving Oral Contraceptives over the Counter
We convened a meeting of 30 Reproductive Justice (RJ) advocates on May 21, 2015 in Washington, DC, to discuss RJ perspectives on moving OCs OTC.
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October 2014, Washington, DC: Annual working group meeting
Our annual OCs OTC working group meeting took place on October 21, 2014 in Washington, DC, and 66 participants were in attendance. Topics covered during the meeting included an update on where we are and the developments over the past year, a recap from a meeting held with reproductive justice advocates in May, cost and insurance coverage of a future OTC OC, politics and OCs OTC, adolescent OTC OC access, communicating key messages about OCs OTC, other strategies to improve access to hormonal contraception, and next steps. You can find the meeting agenda here.
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October 2013, New York, NY: Annual working group meeting
Our annual OCs OTC working group meeting took place on October 23, 2013 in New York, NY, and 59 participants were in attendance. You can find the meeting agenda here.
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October 2012, Washington, DC: Annual working group meeting
On October 22, 2012, the OCs OTC Working Group held a day-long meeting in Washington, DC, to share recent research developments and discuss emerging issues related to an OTC switch for OCs. More than fifty people from over 35 organizations attended the meeting, which featured eight unique panels. Attendees represented a range of groups and interests including research, reproductive rights and justice, women’s health advocacy and policy, pharmaceuticals, and health care provision.

Building on the focus of the previous year’s meeting, the 2012 panels provided an overview of the evidence and history of the working group; updated attendees on recent research findings related to OTC access to OCs, including results of a national survey of women at risk of unintended pregnancy on their interest in OTC access, results from participatory research with young women and women of color on OCs OTC, and results from a study on self-screening for contraindications to combined OCs in Tanzania; discussed OTC contraception and age restrictions, including lessons learned from emergency contraception; discussed progestin-only pills (POPs) as the first OTC OC; detailed recent research on and strategies related to cost and insurance coverage for an OTC OC, including an update on the Affordable Care Act and recent research on insurance coverage strategies for OTC contraception; provided an overview on the FDA’s proposal to expand the category of OTC medications under “conditions of safe use;” and brainstormed next steps in moving forward with an OTC switch, including communications strategies and potential stakeholders to engage.
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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.
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May 2010, Washington, DC: Exploring what the research tells us and collaborating with reproductive health and justice advocates on a strategy moving forward
In May 2010, the working group convened a daylong meeting entitled “Oral contraceptives over-the-counter: Exploring what the research tells us and collaborating with reproductive justice advocates on a strategy moving forward.” Twenty-four people attended the meeting; participants included representatives of reproductive justice, women’s health, and youth-focused organizations. The purpose of the meeting was to explore in greater depth advocates’ concerns and questions about an over-the-counter switch for a progestin-only pill (POP). In addition, participants provided input on working group activities and discussed opportunities for advocates to remain engaged in the working group.

The meeting was organized around the topics of safety, cost, and health services and referrals; “expert resources” were brought to the table to address these topics and contribute to the discussion. Participants in the meeting agreed that a broad-based campaign to bring a POP over-the-counter appears to be supported by the available data on safety, and that an OTC POP product could increase access for some women. The final part of the meeting focused on next steps. Participants shared their questions and priorities for moving forward and also stated how they would like to stay involved in the working group.

During the course of the meeting, advocates developed a shared vision for an advocacy agenda to support an OTC switch. The meeting helped to surface advocates’ most critical concerns: the need to change Medicaid policy to cover all OTC contraceptive products without a prescription; the importance of not having an age restriction; and the need for more research with women of color and low-income women regarding their opinions and interest regarding an OTC switch. Many participants expressed their interest in being involved in activities to address these issues. Over the next two years, we will build on the momentum generated at the meeting and create opportunities for advocates to take on active roles in addressing the cost and age issues and conducting community-based research.
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September 2009, New York, NY: Research, communications, and building new partnerships
In September 2009, the working group held a two-day meeting at the Guttmacher Institute offices in New York. More than 40 people attended, including many who had never participated in the working group before. There were several new advocacy and reproductive justice groups represented, and five pharmaceutical representatives. The meeting focused on the following topical areas: the history of the OCs OTC working group and an update on activities, a review of the regulatory issues related to an OTC switch for OCs, preliminary findings from the stakeholder analysis, an update on recent research findings related to OCs OTC, a review of the economic issues related to an OTC switch for OCs, and pharmacist perspectives on alternative provision models of OCs. The meeting allowed for a great deal of discussion time, including two separate sessions for the communications and research subcommittees.

Among the important outcomes of this meeting were bringing new partners into the working group, especially among women’s health and reproductive justice advocates; a discussion of the working group’s aims that eventually led to a revision of the group’s statement of purpose to incorporate the working group’s commitment to addressing reproductive health disparities; a decision to focus on a POP as the first candidate for an OTC switch; and a decision to focus on the development of materials for a formal meeting with the FDA, including a draft OTC label and protocols for the actual use and label comprehension studies.
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August 2006, New York, NY: Moving forward with research and advocacy
This meeting focused on developing strategies for moving forward with the working group’s planned research and advocacy activities. The Guttmacher Institute reviewed recent analyses showing racial and economic disparities in contraceptive use in the US, and the working group discussed how OTC access might improve contraceptive access for groups of women with high rates of unintended pregnancy.
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February 2006, Washington, DC: Messaging around OTC provision of OCs
This meeting focused on developing messaging around OTC provision of OCs in order to increase support for our efforts and bring additional perspectives to the discussion. We also invited representatives of colleague professional organizations, including the American College of Obstetricians & Gynecologists, Physicians for Reproductive Choice & Health, the Association of Reproductive Health Professionals, Medical Students for Choice, the American Academy of Family Physicians, the National Family Planning & Reproductive Health Association, and the Planned Parenthood Federation of America. A representative of the Consumer Healthcare Products Association also presented information about the criteria for OTC status and the market for OTC medicines in the U.S.
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November 2005, Washington, DC: Questions, opportunities, and concerns raised by the proposal of an OTC switch for oral contraceptives
On November 3, 2005, a group of women’s health advocates met at the Guttmacher Institute offices in Washington, DC to discuss the questions, opportunities, and concerns raised by the proposal of an OTC switch for oral contraceptives, particularly for women who are currently underserved by the health care system. The objectives of the meeting were to: broaden the range of communities weighing in on an oral contraceptive (OC) over-the-counter (OTC) switch and its potential impact; identify critical unanswered questions about the effect of an OTC switch and frame these questions for further research; and create an opportunity for participants to identify and determine whether and how their organizations might participate in effecting the change of making the OTC switch.
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August 2005, Washington, DC: New research on OCs OTC
In August 2005, the working group met to explore new research related to an OTC switch. Research presented at this meeting estimated the proportion of women in the general public in the US and in Mexico that are contraindicated to OC use—the US analysis found that clinician screening for contraindications is not perfect, and the Mexico study found that women who obtained OCs OTC did not have a higher prevalence of contraindications. Meeting participants also discussed a strategy document prepared by Ibis that compared POPs and COCs regarding a possible OTC switch, as well as draft OTC labeling for both products developed by Linda Potter. The Pharmacy Access Partnership presented the results of two surveys, one among women and one among pharmacists, on attitudes toward and interest in pharmacy access to hormonal contraceptives. An investigator from the University of Washington also gave an update on the Direct Access study, a pilot project that allowed women to access hormonal contraceptives from pharmacists without a physicians’ prescription. While the working group was very interested in pharmacist provision as an interim step to improve access to OCs, the group agreed that true OTC provision should remain the ultimate goal.
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December 2004, New York, NY: Reviewing the evidence for the medical contraindications listed in the current OC labeling and guidelines
At this meeting, various experts reviewed the evidence surrounding the medical contraindications listed in the current OC labeling, the FDA’s 2000 and 2004 Guidances for Industry for OC labeling, the WHO’s MEC, and guidelines from other groups. These guidelines were sometimes found to be contradictory, and much of the research used by the FDA as evidence for contraindications was outdated. In addition, the 2004 Draft Guidance for Industry was felt to emphasize risks associated with OCs and excluded information on many non-contraceptive benefits. For several contraindications, such as hypertension, the risk associated with OCs was felt to be less than the risk associated with the same condition complicating an unwanted pregnancy. Still, screening for hypertension was identified as a potentially complicating factor in the push for OTC provision. At this meeting, the group again debated the relative merits of moving forward with an OTC switch for a POP versus a COC product and agreed to explore both possibilities.
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March 2004, Cambridge, MA: Main arguments for and against OTC provision of OCs
This meeting focused on the main arguments for and against OTC provision of OCs, and several strategies were proposed to help move forward with an OTC switch, including re-examining the medical necessity of the contraindications to OC use, developing simpler labeling for an OTC product that might improve compliance, and identifying an entity interested in submitting a switch application. Participants identified areas for future research, including studies of women’s ability to self-screen for contraindications, an actual use study, and economic modeling. The group also had an initial discussion about the merits of pushing for an OTC switch for a progestin-only pill (POP) as opposed to a combined oral contraceptive (COC) and decided to focus efforts on OTC availability of COCs.
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